Management of pseudoaneurysm near the bifurcation of innominate artery with kissing cover stents technique / 中华放射学杂志

ABSTRACT

Objective:To discuss the feasibility, safety and efficacy of kissing cover stents technique in the management of pseudoaneurysm near the bifurcation of innominate artery (the distance <1 cm).Methods:A retrospective study of 10 patients with pseudoaneurysm near the bifurcation of innominate artery were performed in the Affiliated Wuxi People’s Hospital of Nanjing Medical University from May 2013 to August 2018. There were 6 males and 4 females, aged from 25.0 to 77.0 years old, with a median age of 50.5 years old. All patients were treated with Viabahn stents combined with kissing stents. The adverse reactions were observed during the perioperative period, and the patients were followed up to evaluate the stents position and patency. Results:Among 10 patients, 2 were in the distal of innominate artery, 5 were in the bifurcation of innominate artery, 2 were in the root of right common carotid artery and 1 was in the origin of right subclavian artery. The distance from the injury site to the bifurcation of innominate artery was less than 5 mm in 4 cases and 8 mm in 1 case. All of them were successfully treated with Viabahn stents combined with kissing stents. Operation time ranged from 100.0 to 150.0 (122.0±14.9) min. The postoperative hospitalization time was (6.3±1.5) d, ranged from 4.0 to 9.0 d. During the operation, 8 mm×100 mm Viabahn stents were implanted in the right subclavian artery and 10 mm×100 mm Viabahn stents were implanted in the right common carotid artery. There were no severe adverse reactions during the perioperative period. Follow-up time ranged from 12 to 24 months. During the follow-up, color Doppler ultrasound and carotid CT angiography showed that the stents were in appropriate position, the blood flow was unobstructed, and there was no occlusion and displacement of stents. Viabahn stents remained at the level of proximal end of the innominate artery.Conclusion:Viabahn stents combined with kissing stents is a safe and effective treatment for pseudoaneurysm near the bifurcation of innominate artery.