scholarly journals Stent Graft-in-Stent Graft as a Rescue Technique for Endovascular Treatment of Giant Extracranial Internal Carotid Aneurysm

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Adenauer Marinho de Oliveira Góes Junior ◽  
Salim Abdon Haber Jeha

Endovascular treatment of a giant extracranial internal carotid aneurysm by a stent graft implantation was unsuccessful due to a high flow leak directly through the stent graft’s coating. The problem was solved deploying a second stent graft inside the previously implanted one resulting in complete exclusion of the aneurysmal sac and patent carotid lumen preservation. The review of the literature did not provide a case using this endovascular strategy. Follow-up for more than 12 months, using CT angiography, showed confirmed aneurysmal exclusion and carotid patency and no clinical complications have been detected.

2002 ◽  
Vol 9 (6) ◽  
pp. 822-828 ◽  
Author(s):  
Reinhard S. Pamler ◽  
Thomas Kotsis ◽  
Johannes Görich ◽  
Xaver Kapfer ◽  
Karl-Heinz Orend ◽  
...  

Purpose: To outline the complications encountered after endoluminal treatment in patients with type B aortic dissection. Methods: Between 1999 and 2001, 14 patients (12 men; mean age 60.3 years, range 39–79) with isolated type B aortic dissection (13 chronic, 1 acute) underwent aortic stent-grafting. Three patients with chronic dissection presented an acute clinical picture and were managed emergently. The left subclavian artery was intentionally covered by the prosthesis in 9 patients. Follow-up studies were performed at 6-month intervals. Results: Stent-graft implantation was technically successful in all patients, but incomplete sealing (endoleak) of the entry site required additional proximal stent-graft implantation in 4. The left subclavian artery remained patent in 5 patients. Secondary conversion was required in 3 patients: 2 for acute type A dissection resulting from injury to the aortic arch by Talent endografts and a sustained hemorrhage (left hemothorax). In another patient, a secondary intramural hematoma subsided spontaneously. Anterior spinal artery syndrome in 1 patient persisted at 1 month. No bypass was necessary for the 9 patients with the covered left subclavian arteries. Mean follow-up was 14 months (range 1–23). Conclusions: Stent-grafting is feasible in patients with type B aortic dissection, although it is associated with a considerable rate of complications. Frank reporting of these sequelae for a variety of stent-grafts is of paramount importance to clarifying the limitations of the method.


2018 ◽  
Vol 26 (1) ◽  
pp. 72-75
Author(s):  
Fabien Lareyre ◽  
Claude Mialhe ◽  
Carine Dommerc ◽  
Juliette Raffort

Purpose: To report the use of the Nellix endovascular aneurysm sealing (EVAS) system in the management of proximal stent-graft collapse associated with thrombosis following endovascular aneurysm repair (EVAR). Case Report: A 76-year-old man was admitted for proximal collapse of an aortic extension following bifurcated AFX stent-graft implantation associated with chimney grafts in both renal arteries and the superior mesenteric artery 1 month prior. Imaging identified thrombosis of the aortic stent-graft and the iliac limbs. A Nellix EVAS was placed into the AFX stent-graft to recanalize the aneurysm lumen and address the aortic thrombosis. There was no endoleak, and the renovisceral chimney stent-grafts remained patent over a follow-up of 25 months. Conclusion: While further studies are required to generalize its use, EVAS appears to be feasible in the management of aortic stent-graft collapse.


2001 ◽  
Vol 11 (11) ◽  
pp. 2252-2257 ◽  
Author(s):  
Roland Dorffner ◽  
Maria Schoder ◽  
Gerhard Mostbeck ◽  
Thomas Hölzenbein ◽  
Siegfried Thurnher ◽  
...  

2017 ◽  
Vol 18 (1_suppl) ◽  
pp. S74-S76 ◽  
Author(s):  
Rick de Graaf

Swing-segment lesions are a fairly common reason for access failure and predispose to repeated interventions. The pathophysiology, hemodynamic circumstances and the primary intervention might all play a role in early recurrence. Mainly, percutaneous transluminal angioplasty (PTA), bare metal stenting and stent graft implantation have been performed to prolong lesion patency and access circuit patency. The available data on endovascular treatment of swing-segment lesions are scarce, heterogeneous and of poor quality. Moreover, with the continuous evolution of endovascular techniques and introduction of new devices there is a risk of increasing device-specific investigations. In the meantime, PTA is easily discarded in favor of novel stents and stent grafts. However, PTA might still have an important position in the overall treatment strategy to postpone loss of the vascular access site. However, without optimal post-interventional imaging, true PTA results remain obscure and indications for additional stent (graft) implantation unclear. Currently, it seems that different devices are utilized to prolong lesion patency rather than access circuit patency. Obviously, more randomized controlled trials and well-structured multicenter registries may be capable of determining a superior treatment modality for a specific lesion. However, it might be more accurate to identify the optimal sequence of interventions by which the lifespan of the access site is maintained as long as possible.


2015 ◽  
Vol 26 (3) ◽  
pp. 619-622
Author(s):  
Dimitrij Kuhelj ◽  
Pavel Berden ◽  
Tomaž Podnar

AbstractWe report a case of aortic pseudoaneurysm associated with a fractured bare Cheatham-Platinum stent following stenting for aortic coarctation. These complications were recognised 6 years after the implantation procedure and were successfully managed by percutaneous stent graft implantation. Staged approach for stent dilatation might prevent development of aortic pseudoaneurysms. In addition, careful follow-up is warranted after stenting for aortic coarctation, particularly in patients with recognised aortic wall injury.


2002 ◽  
Vol 56 (3) ◽  
pp. 353-360 ◽  
Author(s):  
Ulrich Gercken ◽  
Alexandra J. Lansky ◽  
Lutz Buellesfeld ◽  
Kartik Desai ◽  
Magdy Badereldin ◽  
...  

2002 ◽  
Vol 9 (6) ◽  
pp. 817-821 ◽  
Author(s):  
Won-Heum Shim ◽  
Bon-Kwon Koo ◽  
Young-Sup Yoon ◽  
Donghoon Choi ◽  
Yangsoo Jang ◽  
...  

Purpose: To evaluate the early and midterm outcomes after stent-graft implantation for dissection in the descending thoracic aorta. Methods: Sixteen custom-made endovascular stent-grafts were implanted in 15 patients (10 men; mean age 55.9 ± 13.7 years, range 32–82) with descending thoracic aortic dissection. Indications for stent-graft implantation were persistent symptoms unresponsive to medical treatment or progressive enlargement of the false lumen. Clinical and imaging surveillance with computed tomography was performed within 1 month of the procedure and at 3 to 6-month intervals in follow-up. Results: Endovascular stent-graft implantation at the target site was successful in 14 (93%) patients; 1 device migrated, leaving the false lumen open to flow in the failed case. One (7%) patient who was treated emergently for rupture died suddenly 2 days after the procedure. Over an average follow-up of 31.5 ± 23.8 months, 1 (7%) patient died and 2 (14%) patients underwent surgical treatment due to recurrent dissection. The remaining 10 patients showed complete thrombosis of the false lumen; in 3, the false lumen completely resolved. Conclusions: Endovascular stent-graft implantation in descending thoracic aortic dissection is a feasible, safe, and effective treatment modality. However, further studies are necessary in a greater number of patients to determine if wider application of this minimally invasive procedure is justified.


2015 ◽  
Vol 99 (4) ◽  
pp. 1455 ◽  
Author(s):  
Sylvain Favelier ◽  
Louis Estivalet ◽  
Pierre Pottecher ◽  
Romaric Loffroy

Author(s):  
F. Pedersoli ◽  
V. Van den Bosch ◽  
P. Sieben ◽  
E. Barzakova ◽  
M. Schulze-Hagen ◽  
...  

Abstract Purpose To investigate efficacy and patency status of stent graft implantation in the treatment of hepatic artery pseudoaneurysm. Materials and Methods A retrospective analysis of patients who had undergone endovascular treatment of hepatic artery pseudoaneurysms between 2011 and 2020 was performed. Medical records were examined to obtain patients’ surgical histories and to screen for active bleeding. Angiographic data on vascular access, target vessel, material used and technical success, defined as the exclusion of the pseudoaneurysm by means of a stent graft with sufficient control of bleeding, were collected. Vessel patency at follow-up CT was analyzed and classified as short-term (< 6 weeks), mid-term (between 6 weeks and 1 year), and long-term patency (> 1 year). In case of stent occlusion, collateralization and signs of hepatic hypoperfusion were examined. Results In total, 30 patients were included and of these, 25 and 5 had undergone stent graft implantation and coiling, respectively. In patients with implanted stent grafts, technical success was achieved in 23/25 patients (92%). Follow-up CT scans were available in 16 patients, showing stent graft patency in 9/16 patients (56%). Short-term, mid-term, and long-term short-term stent patency was found in 81% (13/16), 40% (4/10), and 50% (2/4). In patients with stent graft occlusion, 86% (6/7) exhibited maintenance of arterial liver perfusion via collaterals and 14% (1/7) exhibited liver abscess during follow-up. Conclusion Stent graft provides an effective treatment for hepatic artery pseudoaneurysms. Even though patency rates decreased as a function of time, stent occlusion was mainly asymptomatic due to sufficient collateralization.


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