scholarly journals Stent-graft and double-guiding catheter technique to rescue iatrogenic coronary perforation

2021 ◽  
Vol 17 (6) ◽  
pp. 1800-1803
Author(s):  
Ewa Ostrowska ◽  
Aleksandra Gąsecka ◽  
Tomasz Mazurek ◽  
Janusz Kochman
Keyword(s):  
Stent Graft ◽  
Coronary Artery Perforation ◽  
Catheter Technique ◽  
Coronary Perforation ◽  
Percutaneous Coronary ◽  
Life Threatening ◽  
Temporary Closure ◽  
Stent Graft Implantation ◽  
Graft Implantation ◽  
Guiding Catheter

IntroductionCoronary artery perforation (CAP) is an infrequent, yet life-threatening complication of percutaneous coronary interventions, posing a major risk of cardiac tamponade and mortality.Material and methodsWe report on effective management of Ellis type III CAP with use of double-guiding catheter technique and stent-graft implantation.ResultsProlonged balloon inflation via the first guiding catheter allows for temporary closure of the bleeding site. At the same time, stent-graft is inserted via the second guiding catheter to seal the perforation. After rapid deflation of the balloon, the stent is immediately advanced and expanded.ConclusionsThe procedure minimises the time between deflation of the balloon and implantation of the stent-graft, allowing for successful bleeding cessation.

scholarly journals Coronary Perforation- A Nightmare in Cath Lab

2021 ◽  
Author(s):  
Ashok Kumar Thakur ◽  
Puneet Aggarwal ◽  
Rajeev Bharadwaj ◽  
Bhagya Narayan Pandit ◽  
Ranjit Kumar Nath
Keyword(s):  
Coronary Artery ◽  
Standard Of Care ◽  
Coronary Intervention ◽  
Modern Technology ◽  
Coronary Artery Perforation ◽  
Coronary Perforation ◽  
Percutaneous Coronary ◽  
Incidence Risk ◽  
Life Threatening ◽  
Artery Disease

Percutaneous Coronary Intervention (PCI) is now the standard of care in patients with coronary artery disease. With advances in modern technology, the success of PCI has relatively increased, and so is its complication, specifically in complex coronary intervention. Coronary perforation is one of the most dreadful and life-threatening complications of PCI. The most vital step in the management of coronary perforation is its identification and quick action. Multiple methods for management are now recommended in the literature, but the mainstay of treatment is still prevention. This review discusses the incidence, risk factors, prevention, identification, and management of Coronary Artery Perforation (CAP).

scholarly journals Successful Management of Coronary Artery Rupture with Stent-Graft: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Berkay Ekici ◽  
Aycan Fahri Erkan ◽  
Utku Kütük ◽  
Hasan Fehmi Töre
Keyword(s):  
Coronary Artery ◽  
Stent Graft ◽  
Distal Portion ◽  
Metal Stents ◽  
Stent Grafts ◽  
Successful Management ◽  
Coronary Artery Perforation ◽  
Coronary Perforation ◽  
Life Threatening ◽  
Coronary Artery Rupture

Perforation of coronary arteries is a relatively rare yet life-threatening complication of percutaneus coronary interventions and is encountered in approximately 0.5% of these procedures. According to the type of coronary perforation, various methods of correction are employed, ranging from conservative approach to emergency cardiac surgery. Coronary stent-grafts are composed of two metal stents and a polytetrafluoroethylene layer between them. Advent of such stents enabled efficient endovascular repair of coronary artery perforation. We present a case of coronary artery perforation which had occurred during stent implantation for the treatment of a bridged segment in the distal portion of the left anterior descending artery. This perforation was successfully managed by implanting a stent-graft.

scholarly journals Stent grafts implantation in patients with life-threatening aortic conditions – first experience in Kyrgyz Republic

2019 ◽  
Vol 3 (Issue 4) ◽  
pp. 208
Author(s):  
I.Z. Abdyldaev ◽  
S.D. Chevgun ◽  
M.A. Aripov ◽  
I.H. Bebezov ◽  
D. Ch. Cholponbaev ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
False Lumen ◽  
Kyrgyz Republic ◽  
Aortic Diseases ◽  
Stent Grafts ◽  
Life Threatening ◽  
Aortic Intima ◽  
Stent Graft Implantation ◽  
Graft Implantation

Objective: Aortic diseases remain an acute and debatable problem. Among all the aortic pathologies, the most dangerous are dynamic aneurysmal expansion, traumatic dissections and / or aneurysms, pure aortic intima dissections. Contemporary and less invasive treatment method is the stent graft implantation into aorta. This report describes the first experience of thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) in the Kyrgyz Republic in consecutive patients with life-threatening aortic conditions. Methods: Nine patients, who underwent TEVAR and EVAR, were presented after all clinical examinations, echocardiography and computed tomography angiography with various life-threatening aortic diseases. Among the pathologies there were 2 (22.2%) dissections only, traumatic aneurysm 1 (11.1%), aneurysm without dissection 1 (11.1%), aneurysm with intimal dissection 5 (55.6%). Seven patients with dissection had type B (The Stanford classification). Results: TEVAR was performed in eight cases EVAR just in one. All patients reached the 6-month endpoint.  None of the following, such as aneurysm expansion, aneurysm thrombosis or a functioning of false lumen at the sites of the stent graft implantation have been recorded. In addition, no further progression of the false lumen below the implantation zones was visualized. Mean diameter of stent grafts was 31.4 ± 4.8 mm and  188.9 ± 34.6 mm in length. Conclusion: This modest observation showed the effectiveness of stent grafts implantation procedures in various aortic life-threatening conditions, such as aneurysm and / or aortic intima dissection.

Complications after Endovascular Repair of Type B Aortic Dissection

2002 ◽  
Vol 9 (6) ◽  
pp. 822-828 ◽  
Author(s):  
Reinhard S. Pamler ◽  
Thomas Kotsis ◽  
Johannes Görich ◽  
Xaver Kapfer ◽  
Karl-Heinz Orend ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Stent Grafting ◽  
Stent Graft Implantation ◽  
Graft Implantation

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.

scholarly journals Endovascular Aneurysm Sealing of a Collapsed and Thrombosed Aortic Stent-Graft With Renovisceral Chimney Stent-Grafts

2018 ◽  
Vol 26 (1) ◽  
pp. 72-75
Author(s):  
Fabien Lareyre ◽  
Claude Mialhe ◽  
Carine Dommerc ◽  
Juliette Raffort
Keyword(s):  
Stent Graft ◽  
Mesenteric Artery ◽  
Endovascular Aneurysm Repair ◽  
Stent Grafts ◽  
Aortic Thrombosis ◽  
Aortic Stent Graft ◽  
Aneurysm Repair ◽  
Stent Graft Implantation ◽  
Graft Implantation

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.

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