Emergency stent-graft implantation for iatrogenic peripheral arterial rupture.

Abstract

PURPOSE:

We evaluated the experience with and efficacy of stent-grafting for iatrogenic peripheral arterial ruptures.

MATERIALS AND METHODS:

From 2005 to 2009 we performed stent-grafting on four male patients (age 38-67 years) with iatrogenic peripheral arterial ruptures. In patient 1, grointissue necrosis followed a subcutaneous injection and led to femoral arterial rupture. Pseudoaneurysms ruptured in patients 2 and 3 who were undergoing femoral arteriotomy. Patient 1 experienced a ruptured carotid artery during neck surgery. Shock occurred in three of the four patients. Four patients underwent self-expanding stent-grafting (8 mm×60 mm or 8 mm×80 mm) under local anaesthesia.

RESULTS:

Haemorrhages were controlled in all patients. No procedure-related complications occurred. Patient 1 died of lung metastases 13 months after stent-grafting. Follow-up examinations showed that the stent-graft remained patent in patients 1, 2 and 4, whereas stent occlusion occurred after 15 months in patient 3; in this case, a pseudoaneurysm proximal to the stent was identified, and although repeat stent-grafting successfully stopped the bleeding, the patient died of multiple organ failure 1 week later.

CONCLUSIONS:

Emergency stent-grafting is a technically feasible and therapeutically effective modality for treating high-risk patients who experience iatrogenic peripheral arterial ruptures. The efficient treatment of hypotension and early endovascular intervention will improve the prognosis.

• Authors: L Xiao, J Shen, J-J Tong
• Journal: La Radiologia medica (Radiol Med) Vol. 118 Issue 1 Pg. 152-7 (Feb 2013) ISSN: 1826-6983 [Electronic] Italy
• PMID: 22580807 (Publication Type: Journal Article)

Chemical References

• Contrast Media

Topics

• Adult
• Aged
• Aneurysm, False (diagnostic imaging, etiology, surgery)
• Aneurysm, Ruptured (diagnostic imaging, etiology, surgery)
• Angiography
• Blood Vessel Prosthesis Implantation (methods)
• Contrast Media
• Emergency Treatment
• Femoral Artery (injuries)
• Humans
• Iatrogenic Disease
• Male
• Middle Aged
• Peripheral Vascular Diseases (diagnostic imaging, etiology, surgery)
• Stents
• Treatment Outcome
• Ultrasonography