Entrapment of fractured balloon after angioplasty in an AV access using a covered stent

2021 ◽  
pp. 112972982110198
Author(s):  
Sudarshan Krishnamurthy ◽  
Nidhi Reddy Sama ◽  
Ramesh Soundararajan
Keyword(s):  
Endovascular Procedures ◽  
Bare Metal Stent ◽  
Covered Stent ◽  
Metal Stent ◽  
Av Fistula ◽  
Surgical Interventions ◽  
Angioplasty Balloon ◽  
Av Fistulas ◽  
Stage Renal Disease ◽  
End Stage

Fracture of the angioplasty balloon is a known complication during endovascular procedures in arteriovenous (AV) fistulas and grafts. We describe a case of a patient with end-stage renal disease (ESRD) on dialysis with a brachiocephalic AV fistula that had become dysfunctional. After a percutaneous angioplasty procedure during balloon withdrawal, a portion of the balloon fractured and separated due to the balloon being caught in the struts of a previously placed bare metal stent. A covered stent was used to contain the segment of the fractured balloon to the wall of the fistula. The use of a covered stent in jailing the fractured balloon to prevent further complications is not well described. This strategy may be implemented in some circumstances such as this case to avoid surgical interventions.

scholarly journals Medical Adjuvant Therapy in Reducing Thrombosis With Arteriovenous Grafts and Fistulae Use: A Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 27 ◽  
pp. 107602962110638
Author(s):  
Kaleem Ullah ◽  
Maham Bashir ◽  
Noor Ul Ain ◽  
Azza Sarfraz ◽  
Zouina Sarfraz ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Adjuvant Treatment ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Graft Thrombosis ◽  
Av Fistula ◽  
Number Of Patients ◽  
Long Term Follow Up ◽  
Stage Renal Disease ◽  
End Stage

Hemodialysis is required for patients with end-stage renal disease (ESRD) that require arteriovenous (AV) grafts or fistulas for vascular access. These access points are prone to thrombosis. To determine the effect of medical adjuvant therapy on AV graft/fistula patency among patients with ESRD on hemodialysis. Adhering to the PRISMA 2020 statement, a systematic search was conducted until August 20, 2021, with keywords including arteriovenous graft, fistula, patency, thrombosis, hemodialysis, adjuvant treatment. The following databases were searched: PubMed, Scopus, Web of Science, CINAHL Plus, and Cochrane. A random-effects model was employed using Review Manager 5.4 for data analysis. The meta-analysis pooled in 1985 participants with 1000 (50.4%) in the medical adjuvant treatment group. At a snapshot, medical adjuvant therapy reduced the risk for graft thrombosis (RR = 0.64, P = .02). Notable medications included aspirin for graft thrombosis (RR = 0.36, P = .006) and ticlopidine for fistula thrombosis (RR = 0.53, P = .01). Certain antiplatelet therapies (aspirin and ticlopidine) reduced the number of patients with AV fistula/graft thrombosis among patients with high heterogeneity among the trials. Other therapies (fish oil, sulfinpyrazone, clopidogrel, and aspirin/dipyridamole) did not demonstrate significant improvement but may be promising once concrete evidence is available. Potential benefits of anti-platelet therapies may be explored to maintain the potency of AV grafts/fistulas through well-designed placebo-controlled trials and long-term follow-up.

Circumferential stent fracture repaired using a covered stent in a 42-year-old man with coarctation of the aorta

2015 ◽  
Vol 26 (2) ◽  
pp. 375-377
Author(s):  
Fares Ayoub ◽  
Sameeha AlShelleh ◽  
Iyad AL-Ammouri
Keyword(s):  
High Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Aortic Coarctation ◽  
Coarctation Of The Aorta ◽  
Covered Stent ◽  
Stent Fracture ◽  
Ultra High Pressure ◽  
Stage Renal Disease ◽  
End Stage

AbstractWe present a case of circumferential fracture of aortic coarctation stent with severe re-stentosis presenting 16 years after initial stent implantation with end-stage renal disease. The patient was treated with a covered stent using the stent-in-stent technique. The use of an ultra-high-pressure balloon was proved necessary to overcome the tight, non-compliant stenosis.

Microvascular coronary flow comparison in acute myocardial infarction angioplasty treated with a mesh-covered stent versus bare metal stent

2012 ◽  
Vol 13 (2) ◽  
pp. 153
Author(s):  
Dante S. Lindefjeld ◽  
Manuel A. Mendez ◽  
Eduardo Guarda ◽  
Alejandro Martínez ◽  
Osvaldo Pérez ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Flow ◽  
Bare Metal Stent ◽  
Covered Stent ◽  
Bare Metal ◽  
Metal Stent

scholarly journals Grade III Coronary Artery Perforation Following PCI and Unusual Stent Graft Delivery System

2014 ◽  
Vol 15 (2) ◽  
pp. 101-103
Author(s):  
Miodrag Sreckovic ◽  
Nikola Jagic ◽  
Vladimir Miloradovic ◽  
Mladen Tasic ◽  
Dusan Nikolic
Keyword(s):  
Coronary Artery ◽  
Stent Graft ◽  
Bare Metal Stent ◽  
Covered Stent ◽  
Severe Form ◽  
Bare Metal ◽  
Metal Stent ◽  
High Profile ◽  
Coronary Artery Perforation ◽  
Grade Iii

ABSTRACT Coronary perforations are rare but vicious complications of PCI procedures. Ellis type III coronary artery perforation represents the most severe form and demands an urgent solution. It is often necessary to perform pericardiocentesis and utilizise multiple interventional techniques to seal the perforation. Polytetrafluoroethylene (PTFE)-covered stent implantation has become one of the most frequently used percutaneous solutions, but disadvantages of this intervention are its high profile and low device flexibility. In our case, we attempted to improve the deliverability of the PTFE stent graft alone by mounting it on a bare metal stent used as a stent graft carrier.

scholarly journals Anastomotic aneurysm in forearm AV fistula for hemodialysis access: A late complication

2005 ◽  
Vol 58 (3-4) ◽  
pp. 200-202 ◽  
Author(s):  
Sidor Misovic ◽  
Miroljub Draskovic ◽  
Aleksandar Tomic ◽  
Momir Sarac
Keyword(s):  
End Stage Renal Disease ◽  
Late Complication ◽  
Vascular Complications ◽  
Hemodialysis Access ◽  
Av Fistula ◽  
Anastomotic Aneurysm ◽  
Aneurysm Resection ◽  
Stage Renal Disease ◽  
End Stage

This case report describes the treatment of arteriovenous aneurysm and late vascular complications of native arteriovenous fistula (AVF) in a patient with end-stage renal disease. Aneurysm resection was performed and a new vascular access was created at the original site. 8-month follow-up revealed that this treatment was highly successful. .

scholarly journals A Propensity-Matched Comparison for Bare Metal Stent and Covered Stent in the Management of Infrainguinal Arterial Obstructive Disease

2019 ◽  
Vol 58 (6) ◽  
pp. e44-e45
Author(s):  
Walter Dorigo ◽  
Aaron Fargion ◽  
Fabrizio Masciello ◽  
Sara Speziali ◽  
Elena Giacomelli ◽  
...  
Keyword(s):  
Bare Metal Stent ◽  
Covered Stent ◽  
Bare Metal ◽  
Metal Stent ◽  
Obstructive Disease ◽  
Matched Comparison

General Surgery in Patients with End-Stage Organ Disease

2015 ◽  
Author(s):  
Amy R. Evenson ◽  
Ramanathan M. Seshadri ◽  
Jonathan P. Fryer
Keyword(s):  
United States ◽  
Liver Disease ◽  
Renal Disease ◽  
General Surgery ◽  
End Stage Renal Disease ◽  
The United States ◽  
Av Fistula ◽  
End Stage Liver Disease ◽  
Stage Renal Disease ◽  
End Stage

The number of patients with end-stage organ disease in the United States is substantial. Patients with end-stage organ disease are susceptible to all of the surgical problems seen in general surgical practice, with the added comorbidities associated with their organ failure. Hence, understanding of the principles of perioperative patient management is important as part of a general surgery practice. The chapter contains details on general and peripheral vascular surgical procedures, including dialysis access for patients with end-stage renal disease. Details on management of abdominal hernias, cholelithiasis, and disorders of the intestine in patients with end-stage liver disease are provided. Table 1 discusses the advantages and disadvantages of arteriovenous (AV) fistulas versus AV grafts. Table 2 describes “the rule of 6’s” for mature AV fistula. Table 3 has information on potential barriers to peritoneal dialysis. Table 4 is the Child-Pugh-Turcotte classification of severity of liver disease. Table 5 discusses the factors affecting the decision to operate and timing of operation in patients with end-stage liver disease. Figure 1 shows the increasing incidence of end-stage renal disease in the United States. Figure 2 is the five-stage classification system for chronic kidney disease. Figure 3 illustrates the various options for upper extremity AV fistula. This review contains 3 figures, 5 tables, and 68 references.

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