Crush stent technique: A bail out technique to manage occluded iliac stent.

Management of iliac stent thrombosis is challenging. Open surgical repair may be indicated when intraluminally stent catheterization is difficult to perform. The present review reports the crush stent recanalization technique illustrated with the management of a patient with critical limb ischemia associated to iliac stent thrombosis. Crush stent technique has been described in interventional cardiology but remains rarely performed. Few reported cases described this technique for peripheral arterial recanalization, that is stenting through the subintimal space around an occluded stent.

[Percutaneous angioplasty of renal artery stenosis: Short- and long-term results]. / Angioplastie des sténoses de l'artère rénale : résultats à court et à long termes.

INTRODUCTION: Renal artery stenosis (RAS) may be symptomatic. The treatment of these lesions is primarily medical but may sometimes require surgical or endovascular revascularization. RAS angioplasty is well controlled but its results are discussed. The objective of this work was to report the short- and long-term results of the endovascular treatment of renal arteries in our center. METHODS: We report a retrospective study between 2013 and 2018, including patients who received endovascular treatment for severe symptomatic RAS (≥75%). RESULTS: Our population consisted of 17 patients. Mean age was 51.1 years [18-76], sex ratio 2.4. RAS was discovered during work-up for severe renovascular hypertension resistant to medical treatment for 16 patients and rapidly progressive renal failure for one patient. The etiology retained was: atherosclerosis (9 cases), fibromuscular dysplasia (6 cases) and Takayasu's disease (2 cases). The average stenosis rate was 85.9% [75-97%]. We performed simple angioplasty in 47% of the cases and stenting in 53%. The technical success rate was 100%. At 1 month, morbidity-mortality rates were zero. Mean follow-up was 12 months [6-36 months]. Patients with renovascular hypertension experienced a decrease in blood pressure, with discontinuation of antihypertensive therapy in 62.5% of cases and reduction of doses in 37.5% of cases. The permeability rate was 100% at 1 year, 94% at 2 years and 94% at 3 years. One patient had asymptomatic stent thrombosis at the 18th month. The restenosis rate was zero. CONCLUSION: Angioplasty of symptomatic RAS may be indicated as first-line treatment. It is associated with satisfactory results in the short and long terms.