ABSTRACT
PURPOSE: To evaluate endovascular stent-graft placement for management of aortoiliac aneurysms. MATERIALS AND METHODS: Balloon-expandable stents covered with polytetrafluoroethylene were placed in 11 aortoiliac lesions in nine male non-surgical candidates (mean age, 63.5 years). There were six abdominal aortic aneurysms, four iliac artery aneurysms, and one acute pseudoaneurysm from a ruptured iliac artery. Stent-grafts were dilated up to 14 mm (iliac) and 24 mm (aorta). Patients underwent follow-up computed tomography and angiography. RESULTS: Stent-grafts were successfully placed in all 11 cases. There were two complications: a ruptured iliac artery treated with placement of an additional covered stent and a lower-extremity vessel embolization and bowel infarction resulting in death. All stent-grafts remained patent without increased aneurysmal diameter. Three leaks (27%) were detected. Two leaks were treated with placement of additional covered stents. One still is asymptomatic. CONCLUSION: Endovascular treatment of aortoiliac aneurysms with stent-graft devices may be an alternative to surgery.
Subject(s)
Aortic Aneurysm, Abdominal/therapy , Blood Vessel Prosthesis , Iliac Aneurysm/therapy , Stents , Aged , Aortic Aneurysm, Abdominal/diagnostic imaging , Catheterization , Equipment Design , Evaluation Studies as Topic , Feasibility Studies , Humans , Iliac Aneurysm/diagnostic imaging , Male , Middle Aged , Polytetrafluoroethylene , Radiology, Interventional , Stainless Steel , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
We present a rare case of a broken umbilical artery catheter retrieved via a transumbilical approach with biopsy forceps.
Subject(s)
Catheterization, Peripheral/adverse effects , Foreign Bodies/therapy , Umbilical Arteries , Biopsy/instrumentation , Catheterization, Peripheral/instrumentation , Equipment Failure , Foreign Bodies/diagnostic imaging , Humans , Infant, Newborn , Male , Radiography , Umbilical Arteries/diagnostic imagingABSTRACT
PURPOSE: The long-term efficacy of iliac artery stent placement with the Palmaz stent was evaluated for treatment of limb ischemia. PATIENTS AND METHODS: Iliac stent implantation for limb ischemia was performed on 108 limbs in 83 patients. Eighty patients (96.4%) were followed up clinically from 1 to 70 months (mean, 25.8 months), and 30 patients (37.5%) were followed up with angiography from 1 to 48 months (mean, 10.4 months). Patients were classified into six categories by using an ischemic ranking profile. Clinical success was defined as a minimum one-category improvement from preprocedure ranking. RESULTS: The clinical success rate was 98.9% immediately after the procedure and 86.2% at 48 months. Long-term success was statistically more common in patients with higher preprocedure and lower postprocedure ischemic ranking, and in patients without diabetes. Arteriography demonstrated a primary patency rate of 87.5% at latest follow-up, with five occlusions (12.5%) and only two (5.0%) restenoses. Average stenosis was 17.8% at 6 months and 24.7% at 2 years. Stent restenosis was statistically more common with a higher postprocedure pressure gradient. The complication rate was 9.7%, and 30-day mortality was 1.2%. CONCLUSION: Long-term clinical and angiographic follow-up demonstrates iliac artery stent placement with the Palmaz stent is safe and efficacious for treatment of limb ischemia.