Covered Stent angioplasty for iliac artery in-stent restenosis: Midterm Results

Transcription

1 Covered Stent angioplasty for iliac artery in-stent restenosis: Midterm Results Poster No.: C-0510 Congress: ECR 2012 Type: Scientific Exhibit Authors: A. Chatziioannou 1, K. Palialexis 1, K. Katsenis 1, A. Dalakidis 2, E. C. Keywords: DOI: Primetis 1, V. Koutoulidis 1, A. Gouliamos 1, D. Mourikis 1 ; 1 Athens/ GR, 2 Voula/GR Interventional vascular, Catheter arteriography, Angioplasty, Arteriosclerosis /ecr2012/C-0510 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 6

2 Purpose To evaluate the safety and efficacy of an endoluminal prosthesis for treatment of iliac artery in-stent restenosis (ISR). Methods and Materials 25 consecutive patients referred for percutaneous treatment of an angiographically proven symptomatic iliac artery ISR. All patients presented with recurrent chronic limb ischemia that had deteriorate over an average period of 45 months after bare stenting. A balloon expandable Covered stent angioplasty was performed to all affected limbs and satisfactory result was verified angiographically. Appropriate antiplatelet treatment was administeredafter the procedure. Images for this section: Page 2 of 6

3 Table 1: Characteristics of study patients: risk factors and their distribution by gender Fig. 1: a) IA DSA demonstrates considerable focal restenosis in the middle of a bare stent in the right common iliac artery (CIA) and moderate diffuse restenosis in a bare stent in the left CIA. b) Lessions were treated with kissing covered stents, dilated up to 9 mm. Page 3 of 6

4 Fig. 2: a) Total occlusion of a bare stent. b) Occlusion was revascularized and a covered stent was placed, which was dilated to 9 mm Page 4 of 6

5 Results No acute major complications occurred. 2 patients experienced total reocclusion, both within the first 6 months after the procedure. Both patients had experienced total occlusion of their bare metal stents. Conclusion The use of a balloon expandable covered stent, including the new ones with lower profiles, seems to have promising results when used in iliac artery in stent restenosis. References [1] Di Mario C, Marsico F, Adamian M, et al. New recipes for in-stent restenosis: cut, grade, roast, or sandwich the neointima? Heart. 2000; 84: [2] Tsetis D, Anna Maria Belli, Robert Morgan, et al. Preliminary experience with cutting balloon angioplasty for iliac artery in-stent restenosis. J Endovasc Ther. 2008;15: [3] Cormier F, Ayoubi AA, Laridon D, et al. Endovascular treatment of iliac aneurysms with covered stents. Ann Vasc Surg. 2000;14: [4] Brunkwall J, Lindblad B, Ivancev K, et al. Iatrogenic AV fistula treated by a graftcovered self-expandable stent. Eur J Vasc Endovasc Surg. 1996;12: [5] Rubin BG, Sicard GA. The Hemobahn endoprosthesis: a self-expanding polytetrafluoroethylene- covered endoprosthesis for the treatment of peripheral arterial occlusive disease after balloon angioplasty. J Vasc Surg. 2001;33: S [6] Lammer J, Dake MD, Bleyn J, et al. Peripheral arterial obstruction: prospective study of treatment with a transluminally placed self-expanding stent-graft. Radiology. 2000; 217; [7] Gaxotte V, Laurens B, Haulon S, et al. Multicenter trial of the Jostent balloonexpandable stent-graft in renal and iliac artery lesions. J Endovasc Ther. 2003; 10: [8] Wiesinger B, Beregi JP, Oliva VL, et al. PTFE-covered self-expanding nitinol stents for the treatment of severe iliac and femoral artery stenoses and occlusions: final results from a prospective study. J Endovasc Ther. 2005; 12: Page 5 of 6

6 [9] Hausegger KA, Lammer J, Klein GE, et al. Percutaneous recanalization of pelvic artery occlusions- fibrinolysis, PTA, stents [in German]. Rofo. 1991;155: [10] Cikrit DF, Gustafson PA, Dasling MC, et al. Long-term follow-up of the Palmaz stent for iliac occlusive disease. J Vasc Surg. 1995;118: [11] Becquemin JP, Allaire E, Qvarfordt P, et al. Surgical transluminal iliac angioplasty with selective stenting: long-term results assessed by means of duplex scanning. J Vasc Surg. 1999;23: [12] Schurmann K, Mahnken A, Meyer J, et al. Long-term results 10 years after iliac artery stent placement. Radiology. 2002;224: [13] Marin J, Veith F, Cynamon J, et al. Effect of polytetrafluoroethylene covering of Palmaz stents on the development of intimal hyperplasia in human iliac arteries. J Vasc Interv Radiol 1996; 7: [14] Kessel DO, Wijesinghe LD, Robertson I, et al. Endovascular stent-grafts for superficial femoral artery disease: results of 1-year follow-up. J Vasc Interv Radiol. 1999;10: [15] Lammer J, Dake MD, Bleyn J, et al. Peripheral arterial obstruction: prospective study of treatment with a transluminally placed self-expanding stent-graft. International Trial Study Group. Radiology. 2000;217: [16] Deutschmann HA, Schedlbauer P, Berczi V, et al. Placement of Hemobahn stentgrafts in femoropopliteal arteries: early experience and midterm results in 18 patients. J Vasc Interv Radiol. 2001;12: [17] Ahmadi R, Schillinger M, Maca T, et al. Femoropopliteal arteries: immediate and long-term results with a Dacron-covered stent-graft. Radiology. 2002;223: [18] Krajcer Z, Sioco G, Reynolds T. Comparison of Wallgraft and Wallstent for treatment of complex iliac artery stenosis and occlusion. Tex Heart Inst J. 1997;24: [19] Marin ML, Veith FJ, Cynamon J, et al. Transfemoral endovascular stented graft treatment of aortoiliac and femoropopliteal occlusive disease for limb salvage. Am J Surg. 1994;168: Personal Information Page 6 of 6