ABSTRACT
This case report aimed to evaluate the efficacy of applying VIABAHN endoprosthesis at the dissection re-entry of the right renal artery after thoracic endovascular aortic repair (TEVAR) in a patient with a chronic type B dissected thoracoabdominal aneurysm. A 78-year-old man was given a diagnosis of type B aortic dissection 5 years ago and underwent a successful TEVAR operation. Two years later, he developed complications such as chronic expanding aortic dissections ; thus, he underwent a second endovascular repair. Enhanced computed tomography (CT) scanning at the five-year follow-up after initial endovascular repair showed a 58-mm diameter thoracoabdominal dissected aneurysm. It also showed an apparent entry point dissection arising from the lower thoracic aorta and a re-entry point at the base of the right renal artery. Although the right renal artery was affected by the dissecting false lumen, all other abdominal branches were intact. He was treated with VIABAHN via occlusion of the re-entry of the dissection and reconstruction of the right renal artery. The patient recovered uneventfully and was discharged 10 days after the operation. Postoperative enhanced CT scanning showed that the aortic false lumen was completely thrombosed, and the right renal arterial flow had significantly improved. Although TEVAR is the standard treatment in acute complicated type B dissections, its role in chronic type B dissections remains controversial. Our technique of using VIABAHN for the reconstruction of the right renal artery showed promising results for patients with chronic type B dissections.
ABSTRACT
Objective To evaluate short and medium term therapeutic effects of VIABAHN-covered stent in treat-ment of arteriosclerosis obliterans in lower extremity. Methods Among all 53 cases of arteriosclerosis obliterans in lower extremity with C/D TASC levels, 22 patients underwent VIABAHN-covered stent (stent group), while the other 31 patients were treated with femoral-popliteal artery bypass grafting surgery (graft group). The arterial patency rates were analyzed 3 and 6 months after the two different surgeries. Results The number of arterial patency cases were 28 (90.3%) at 3 months and 26 (83.9%) at 6 months in stent group while it is 22 (100%) at 3 months and 21 (95.5%) at 6 months in graft group. There were no significant differences in the arterial patency rate at 3 months and 6 months between the two different surger-ies (χ2 is 0.808 and 0.760 respectively, P>0.05). Conclusion VIABAHN-covered stent can be used as the preferred treat-ment for arteriosclerosis obliterans of lower extremity.
ABSTRACT
Objective To investigate methods and results of endovascular treatment in TASC (Ⅱ) D-type femoral artery occlusion. Methods From January 2012 to May 2013, 26 cases (26 branches) of superficial femoral artery occlusion with endovascular treatment of TASC (Ⅱ) D-type superficial femoral artery occlusion were retrospectively reviewed. The effi-cacy was evaluated through ABI, CTA, DSA and symptoms improved. Results 26 branches were treated with endovascular methods. Technical success rate was 80.7%(21/26), including 13 branche with stent implantation, 6 branches with Silver-hawk atherectomy and 2 branches with Viabahn stent implantation. All patients were followed up for a mean period of (10.3 ± 1.2)months, primary patency rates at 6 months were 69.2%in stent group, 66.7%in Silverhawk atherectomy group and 100%in Viabahn stent group. Conclusion Endovascular treatment of TASC (Ⅱ) D-type femoral artery occlusion can lead to satisfactory short term patency rates, and Viabahn stent is the latest treatment.