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Iliac stenting

Robert M Van Haren, Lee J Goldstein, Omaida C Velazquez, Jagajan Karmacharya, Arash Bornak
OBJECTIVE: Aortobifemoral bypass has been the gold standard treatment for extensive aortoiliac occlusive disease. Endovascular therapy and stenting of aortic and iliac occlusive lesions has proven to be efficacious, especially when dealing with short segment lesions. Endovascular treatment of TransAtlantic Inter-Society Consensus II (TASC) D aortoiliac occlusive lesions remains a challenge, but a valuable treatment option in poor surgical candidates. We present our operative technique and midterm results in treating TASC D aortoiliac occlusive disease using unibody bifurcated endografts...
October 17, 2016: Journal of Vascular Surgery
Johnathon C Rollo, Steven Farley, Adam Oskowitz, Warren Chow, Juan Carlos Jimenez, Brian Derubertis
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
K K Bredahl, M Taudorf, L Lönn, K C Vogt, H Sillesen, J P Eiberg
OBJECTIVE/BACKGROUND: Surveillance after endovascular aortic aneurysm repair (EVAR) is mandatory and computed tomography angiography (CTA) is considered the standard imaging modality, although patients are exposed to ionizing radiation and nephrotoxic contrast medium. The primary aim of this study was to determine the diagnostic efficacy of duplex ultrasound (DUS) and contrast enhanced ultrasound (CEUS) using CTA as the gold standard. The secondary aim was to determine the clinical consequences of endoleaks missed by DUS and CEUS, or CTA...
October 16, 2016: European Journal of Vascular and Endovascular Surgery
Shigemitsu Shirai, Keisuke Hirano, Norihiro Kobayashi
It is difficult to treat a thrombotic embolism in the common femoral artery or popliteal artery (POP A), i.e., the non-stenting zone. We report a new technique for the treatment of thrombotic embolism in the non-stenting zone using a self-expandable nitinol stent. Case 1 had an external iliac artery (EIA) occlusion that occurred over several months. A self-expandable nitinol stent was placed in the right EIA lesion via a retrograde approach using a distal 9-Fr balloon protection guide catheter in the right femoral artery...
October 19, 2016: Catheterization and Cardiovascular Interventions
J J Jiang, H K Qing, X M Zhang, X M Zhang, W Li, C Y Shen, Q L Li, Y Jiao
OBJECTIVE: To compare total percutaneous access using preclose technique with femoral artery cut-down in endovascular aneurysm repair (EVAR) and assess the safety and feasibility of preclose technique. METHODS: In the study, 81 cases undergoing EVAR from Dec. 2011 to Nov. 2014 in Peking University People's Hospital were retrospectively reviewed. Preoperative CT angiography (CTA) showed presence of infrarenal abdominal aortic aneurysm or descending aortic aneurysm in all the cases...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Sooyeon Kim, Sage P Kramer, Adam J Dugan, David J Minion, John C Gurley, Daniel L Davenport, Victor A Ferraris, Sibu P Saha
BACKGROUND: Iliac arterial stenting is performed both in the operating room (OR) and the catheterization lab (CL). To date, no analysis has compared resource utilization between these locations. METHODS: Consecutive patients (n = 105) treated at a single center were retrospectively analyzed. Patients included adults with chronic, symptomatic iliac artery stenosis with a minimum Rutherford classification (RC) of 3, treated with stents. Exclusion criteria were prior stenting, acute ischemia, or major concomitant procedures...
October 12, 2016: International Journal of Surgery
Erik Groot Jebbink, Varghese Mathai, Johannes T Boersen, Chao Sun, Cornelis H Slump, Peter C J M Goverde, Michel Versluis, Michel M P J Reijnen
BACKGROUND: Endovascular treatment of aortoiliac occlusive disease entails the use of multiple stents to reconstruct the aortic bifurcation. Different configurations have been applied and geometric variations exist, as quantified in previous work. Other studies concluded that specific stent geometry seems to affect patency. These variations may affect local flow patterns, resulting in different wall shear stress (WSS) and oscillating shear index (OSI). The aim of this study was to compare the effect of different stent configurations on flow perturbations (recirculation and fluid stasis), WSS, and OSI in an in vitro setup...
October 12, 2016: Journal of Vascular Surgery
Kenichiro Sato, Ryo Itagaki, Kenshiro Arao, Kouzou Makita
A 44-year-old man was transported to our hospital with chief complaints of back pain and paralysis of the leg. Contrast-enhanced computed tomography (CT) imaging revealed an acute Stanford B aortic dissection (AD), which was complicated by acute arterial occlusion of the left external iliac artery. The patient was treated by femorofemoral crossover bypass. Thereafter, abdominal pain was noted, and the patient was diagnosed with intestinal ischemia due to occlusion of the celiac artery and superior mesenteric artery (SMA)...
2016: Annals of Vascular Diseases
Jips J Zachariah, Justin A Ratcliffe, Michael Ruisi, Joseph Puma, Olivier Bertrand, Tak Kwan
OBJECTIVE: To demonstrate the safety and feasibility of the transpedal approach as an alternate arterial access site for iliac artery intervention. BACKGROUND: The common femoral artery is the traditional access site for the endovascular treatment of iliac artery stenoses. However, this approach is associated with complication rates as high as 2%, including retroperitoneal bleeding which carries high patient morbidity and mortality. Furthermore, the standard femoral approach is associated with longer recovery times and longer time to ambulation which are important considerations especially when performing procedures in an ambulatory setting...
September 18, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Marie-Tiphaine Falcoz, Nicolas Falvo, Serge Aho-Glélé, Emmanuel Demaistre, Christophe Galland, Sylvain Favelier, Pierre Pottecher, Olivier Chevallier, Bernard Bonnotte, Sylvain Audia, Maxime Samson, Béatrice Terriat, Marco Midulla, Romaric Loffroy
BACKGROUND: Post-thrombotic syndrome (PTS) is a frequent complication of deep vein thrombosis (DVT) despite adequate treatment. Venous angioplasty and stent placement has been progressively used to restore and maintain venous patency in PTS patients. This study reports our single-center experience with the use of endovascular treatment for chronic post-thrombotic symptomatic ilio-femoral venous obstructive lesions. METHODS: A prospective mono-centric observational cohort study of PTS patients with chronic symptomatic ilio-femoral venous obstructive lesions referred for endovascular treatment was conducted from March 2012 to April 2016...
August 2016: Quantitative Imaging in Medicine and Surgery
Pierre Maitrias, Gwendoline Deltombe, Valérie Molin, Thierry Reix
OBJECTIVE: Iliofemoral endarterectomy with external iliac artery (EIA) stent grafting can be an alternative to traditional open surgery in patients with severe iliac occlusive disease extending to the common femoral artery. We report the midterm outcomes of this approach. METHODS: Between 2009 and 2015, 108 patients (76% male; median age, 63 years) underwent a total of 127 iliofemoral endarterectomies combined with EIA stent grafting. Indications were claudication in 60%, rest pain in 20%, ulceration in 15%, and acute ischemia in 5%...
September 29, 2016: Journal of Vascular Surgery
C Harzendorf, A Schmidt, T Hirsch
Prostate carcinomas are often associated with lymphedemas of the leg following surgical treatment. Lymphedema is treated using complete decongestive therapy (CDT) with manual lymph drainage and compressive bandaging or stockings. Lymphedema resulting from a distinct iliac lymph node metastasis is a rare condition. A 73-year-old patient with a diagnosed prostate carcinoma presented with distinct swelling in the right leg. Iliac and leg vein thrombosis could not be ruled out. An ultrasound image revealed a large lesion surrounding the right iliac arteries...
September 29, 2016: Der Internist
Andrea Siani, Federico Accrocca, Gennaro De Vivo, Federica Mounayergi, Luca Maria Siani, Roberto Antonelli
The Ovation Abdominal Stent Graft System is a trimodular endoprosthesis planned to overcome the limitations of currently available stent grafts, allowing through complex iliac and femoral access and providing a proximal seal in challange infrarenal neck morphology. The proximal sealing is achieved by means of a network of inflatable rings filled with low-viscosity radiopaque polyethylene glycol (PEG) based polymer during stent graft deployment. The leakage of polymer outside the channel to fill the rings into the vascular system may induce an hypersensitivity reaction and anaphylactic shock...
September 23, 2016: Annals of Vascular Surgery
Animesh Rathore, Peter Gloviczki, Haraldur Bjarnason
Persistent pain after iliac vein stenting is rare. Surgical removal of two oversized (20-mm) iliac vein stents was performed in a 36-year-old woman because of severe back pain of 2½ years' duration. Clamping or venotomy were not required for stent removal, which was done by extraction of each wire of the stent through small puncture wounds in the vein wall. Duplex scanning confirmed residual pseudointima obstructing the orifice of the right common iliac vein. The pseudointima was surgically removed. The patient recovered without complications, and her pain completely resolved...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Ralph L M Kurstjens, Timme M A J van Vuuren, Mark A F de Wolf, Rick de Graaf, Carsten W K P Arnoldussen, Cees H A Wittens
OBJECTIVE: Chronic deep venous obstruction can cause a significant loss of quality of life, although it can be treated successfully by stenting. A clear referral pattern for additional imaging is warranted in patients with lower limb complaints. The aim of this study was to determine the value of clinically visible abdominal wall collateral veins in the diagnosis of a potentially treatable deep venous obstruction. METHODS: A total of 295 patients referred for evaluation at a tertiary venous clinic with a collateral vein on the abdominal wall or pubic bone, visible on physical examination, were retrospectively analyzed and compared with a randomly selected control group of 365 patients without such a collateral vein...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Efthymios D Avgerinos, Omar El-Shazly, Geetha Jeyabalan, George Al-Khoury, Eric Hager, Michael J Singh, Michel S Makaroun, Rabih A Chaer
BACKGROUND: Inferior vena cava (IVC) thrombosis may occur in patients with iliofemoral deep venous thrombosis (DVT), and its impact on thrombolysis outcomes is poorly defined. This study compared outcomes of patients undergoing thrombolysis for acute iliofemoral DVT with and without IVC involvement. METHODS: Patients who underwent thrombolysis for iliofemoral DVT between May 2007 and March 2014 were identified from a prospectively maintained database and divided into two groups: those with IVC involvement and those without...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Masami Shingaki, Masaaki Kato, Manabu Motoki, Yoji Kubo, Toshihiko Isaji, Nobukazu Okubo
An 86-year-old man with an abdominal aortic aneurysm was diagnosed with type B aortic dissection accompanied by a patent false lumen that started at the distal arch of the thoracic aorta and terminated at the left common iliac artery. Meticulous preoperative assessment detected 3 large intimal tears in the descending aorta, abdominal aortic aneurysm, and left common iliac artery. We performed single-stage thoracic and abdominal endovascular aneurysm repair and concomitant axillary-axillary bypass. The abdominal aortic aneurysm with type B aortic dissection was successfully treated using a single-stage endovascular stent graft, without any complications due to the careful preoperative examinations...
September 15, 2016: Asian Cardiovascular & Thoracic Annals
Walter Dorigo, Gabriele Piffaretti, Filippo Benedetto, Antonino Tarallo, Patrizio Castelli, Francesco Spinelli, Aaron Fargion, Carlo Pratesi
OBJECTIVE: The aim of this study was to retrospectively compare early and late results of aortobifemoral bypass and endovascular recanalization with the kissing stent technique in the management of TransAtlantic Inter-Society Consensus II (TASC II) C and D lesions in the aortoiliac district in a multicenter study. METHODS: From January 2006 to December 2013, 210 open and endovascular interventions for TASC II class C and D aortoiliac obstructive lesions were performed at three Italian teaching hospitals...
September 12, 2016: Journal of Vascular Surgery
A V Pokrovskiĭ, I M Ignat'ev, M Iu Volodiukhin, E G Gradusov
The present study was aimed at assessing initial results of hybrid operations in obstructive lesions of the iliac-femoral veins in patients with post-thrombotic disease (PTD). Hybrid operations [open endovenectomy from the common femoral vein (CFV) with creation of an arteriovenous fistula + stenting of iliac veins] were performed carried out in a total of eleven patients with PTD. Of these, there were 7 men and 4 women aged from 34 to 52 years (mean age - 42.8±7 years). All patients had severe-degree chronic venous insufficiency (CVI)...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Jae Hoon Lee, Ki Hyuk Park
PURPOSE: Iliac extension of stent-graft during endovascular aneurysm repair (EVAR) increases the incidence of limb occlusion (LO). Hypothetically, adjunctive iliac stent (AIS) could offer some additional protection to overcome this anatomic hostility. But still there is no consensus in terms of effective stent characteristics or configuration. We retrospectively reviewed our center's experience to offer a possible answer to this question. METHODS: Our study included 30 patients (38 limbs) with AIS placed in the external iliac artery (EIA) from January 2010 to December 2013...
September 2016: Annals of Surgical Treatment and Research
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