Emergency and elective implantation of covered stent systems in iatrogenic arterial injuries

To evaluate the effectiveness and safety of covered stents for the management of iatrogenic arterial injury. Between 03 / 1998 and 12 / 2009, 31 patients underwent selective covered stent implantation after iatrogenic arterial injury. 12 / 31 of these patients (38.7 %) were hemodynamically unstable....

Full description

Saved in:

Bibliographic Details
Published in:	RöFo : Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebende Verfahren Vol. 183; no. 7; p. 618
Main Authors:	Goltz, J P, Bastürk, P, Hoppe, H, Triller, J, Kickuth, R
Format:	Journal Article
Language:	English
Published:	Germany 01-07-2011
Subjects:	Adult Aged Aged, 80 and over Aneurysm, False - therapy Angiography, Digital Subtraction Arteries - injuries Emergencies Extravasation of Diagnostic and Therapeutic Materials - diagnosis Extravasation of Diagnostic and Therapeutic Materials - therapy Female Follow-Up Studies Hemorrhage - mortality Hemorrhage - therapy Humans Iatrogenic Disease Male Middle Aged Prosthesis Design Prosthesis Failure Retreatment Retrospective Studies Stents Survival Rate Tomography, X-Ray Computed Ultrasonography, Doppler, Color Vascular System Injuries - diagnosis Vascular System Injuries - mortality Vascular System Injuries - therapy
Online Access:	Get more information
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	To evaluate the effectiveness and safety of covered stents for the management of iatrogenic arterial injury. Between 03 / 1998 and 12 / 2009, 31 patients underwent selective covered stent implantation after iatrogenic arterial injury. 12 / 31 of these patients (38.7 %) were hemodynamically unstable. Six different endovascular covered stent types were utilized. The primary endpoints of this study were technical and clinical success and rates of minor and major complications. Initial angiograms demonstrated active extravasation in 19 (61.3 %) patients and pseudoaneurysms in 12 (38.7 %) patients. The following sites of bleeding origin were detected: axillary artery, subclavian artery, common iliac artery, external iliac artery, internal iliac artery, common femoral artery, superficial femoral artery, popliteal and fibular artery, femoro-popliteal and popliteo-crural bypasses, common hepatic artery, aberrant hepatic artery, cystic and gastroduodenal artery. In all patients bleeding was effectively controlled by covered stent implantation resulting in an immediate technical success of 100 %. Clinical success attributed to covered stent implantation was documented in 30 of the 31 patients (96.8 %). Major complications included death in four patients (11.1 %), acute thrombosis with arm ischemia in one patient (2.8 %) and stent fracture with associated pseudoaneurysm in another patient (2.8 %). In 2 / 31 patients (6.5 %) covered stent failure was detected and successfully treated by implantation of a second covered stent. Emergency and elective implantation of covered stents may be used for minimally invasive and effective management of iatrogenic arterial injury.
ISSN:	1438-9010
DOI:	10.1055/s-0029-1246077