Relining technique for continuous sac enlargement and modular disconnection secondary to endotension after endovascular aortic aneurysm repair

Endotension is an unpredictable late complication of endovascular aortic aneurysm repair (EVAR). This case report will discuss the successful treatment of enlarged aneurysmal sac due to endotension using the relining technique. An 81-year-old male complained of nondecreasing huge aneurysm sac. He had undergone EVAR for infrarenal abdominal aortic aneurysm 7 years prior and no endoleak was found through follow-up. Initially computed tomography-guided sac aspiration was tried, but in vain, Relining using the double barrel technique and tubular endograft for modular diconnection, which was unexpectedly found in the original endograft, were performed sucessfully. During follow-up after the relining procedure, the size of aneurysm sac continued to decrease in size. The relining technique is effective mothod for treating endotension.

Early Results of Stenting for Chronic Artherosclerotic Occlusive Disease of Superficial Femoral Artery / 대한혈관외과학회지

PURPOSE: The purpose of this study is to evaluate the results of femoral artery stenting as a treatment of femoral artery occlusive disease, and to compare the primary patency and target lesion revascularization (TLR). METHODS: A retrospective review identified 38 patients who underwent femoral artery stenting from November 2008 to December 2010 in Inha University Hospital. Each lesion was classified according to the Trans-Atlantic Inter-Society Consensus II. Demographic, preoperative, intraoperative, and postoperative variables were collected. RESULTS: Forty cases of femoral artery stenting were done for 38 patients. The indications were claudication (47.4%), rest pain (13.2%), unhealed ulcer (13.2%), and toe gangrene (26.3%). The mean age and mean body mass index (BMI) were 72.50+/-8.19 years, and 23.0+/-0.05 kg/m2. There were 57.9% diabetes mellitus, 65.8% hypertension, 44.7% ischemic heart disease, 39.5% current smoker, 71.1% hyperlipidemia, 28.9% chronic renal failure (creatinine>1.5), 23.7% obesity (BMI>25), and 10.5% stroke. The mean follow-up was 12.1+/-0.03 months. There were no in-hospital mortality and 3 complications: 1 femoral artery dissection and 2 branch perforations. Six patients died and two symptomatic stent fractures were noted during the follow-up. One years' primary patency rate and TLR rate were 81.1% and 5.5%. CONCLUSION: Femoral artery stenting showed good results and can be a reasonable option. TLR can be considered as a new standard to evaluate the endovascular treatment.