共查询到20条相似文献,搜索用时 15 毫秒
1.
In a 24-year-old woman, an iliac pseudoaneurysm following lumbar discectomy was successfully treated by percutaneous placement
of a self-expanding stent-graft. A postprocedural angiogram demonstrated complete exclusion of the pseudoaneurysm without
leakage of contrast agent. 相似文献
2.
Jeannette Bakker M.D. Pierre P. Goffette Michel Henry Willem P. T. M. Mali Jean-Pierre Melki Jon G. Moss Claudio Rabbia Eric Therasse Kenneth R. Thomson Siegfried Thurnher Claudio Vignali 《Cardiovascular and interventional radiology》1999,22(6):468-474
Purpose: To assess, in a multicenter setting, safety, technical results, and restenosis rate of the Palmaz stent for treatment of
atherosclerotic ostial renal artery stenosis.
Methods: Ten centers enrolled 106 patients (120 treated renal artery stenoses) in the study. Patient selection was based on unsuccessful
percutaneous transluminal renal angioplasty (residual stenosis ≥ 20%) performed for treatment of ostial stenosis ≥ 50%, in
patients with hypertension and/or impaired renal function. Safety was assessed by means of the complication rate, and technical
results by the number of successful stent placements and occurrence of restenosis (>50%) at intraarterial angiographic follow-up.
Results: Stent placement was successful (n = 112) or partially successful (n = 5) in 117 (98%) arteries. Complications occurred in 19 procedures; seven were of serious clinical significance. Angiographic
follow-up was performed in 89 of 117 (76%) cases, at a mean of 8 months (range 2.5–18 months). Fifteen stents (16.9%) showed
restenosis (at a mean of 8.5 months), of which 10 were successfully redilated.
Conclusion: Renal artery stenting has a high technical success rate, a complication rate comparable to percutaneous transluminal renal
angioplasty, and a low rate of restenosis at 8 months angiographic follow-up. 相似文献
3.
Shireesha G. Reddy Christopher P. Rothstein Mark B. Saker Richard A. Kane Robert J. March Terence A.S. Matalon 《Cardiovascular and interventional radiology》1998,22(2):152-154
We describe a technique for transfemoral endovascular exclusion of an iliac artery aneurysm with a reconstrained polytetrafluoroethylene
(PTFE)-covered Wallstent inserted through a 12 Fr sheath after right femoral artery cutdown. The procedure was successfully
performed, with evidence of complete aneurysm exclusion at 4-month follow-up. This technique reduces the caliber of the introducer
needed to deploy the covered Wallstent. It should be noted that because of a leak, an additional covered Palmaz stent was
also deployed. 相似文献
4.
Therapeutic Consequences of Variation in Intraarterial Pressure Measurements After Iliac Angioplasty
Eric Tetteroo Cees Haaring Andries D. van Engelen Yolanda van der Graaf Willem P.T.M. Mali 《Cardiovascular and interventional radiology》1997,20(6):426-430
Purpose: To assess the accuracy of intraarterial measurement of transstenotic pressure gradients for the detection of hemodynamically
suboptimal iliac angioplasty.
Methods: In 14 patients, referred for diagnostic angiography, mean pressure gradients in the aorta and iliac artery were obtained
twice, using a double-sensor pressure catheter. Additional iliac measurements were performed during pharmacologically induced
flow augmentation. Repeatability was assessed by calculation of the mean difference plus standard deviation (MD ± SD) and
repeatability coefficient (2 × SD). These results were extrapolated to 137 iliac angioplasty procedures with secondary stenting
where there was a residual pressure gradient > 10 mmHg.
Results: MD ± SD for repeated measurements at rest and during flow augmentation were 0 ± 2 mmHg and 1 ± 3 mmHg, respectively. Repeatability
coefficients were 3 and 6 mmHg. Mean pressure gradients after hemodynamically insufficient angioplasty were 8 ± 7 mmHg at
rest and 17 ± 5 mmHg following vasodilatation. Inaccurate pressure recordings may have led to inappropriate stent placement
in less than 2.5%, and inappropriate denial of stent placement in less than 5% of the lesions.
Conclusion: Variability of intraarterial pressure measurements has little consequence in the detection of hemodynamically significant
stenosis after angioplasty.
Received: 0/00/00/Accepted: 0/00/00 相似文献
5.
Primary stenting in infrarenal aortic occlusive disease 总被引:5,自引:5,他引:0
Nyman U Uher P Lindh M Lindblad B Ivancev K 《Cardiovascular and interventional radiology》2000,23(2):97-108
Purpose: To evaluate the results of primary stenting in aortic occlusive disease.
Methods: Thirty patients underwent primary stenting of focal concentric (n = 2) and complex aortic stenoses (n = 19), and aortic or aorto-iliac occlusions (n = 9). Sixteen patients underwent endovascular outflow procedures, three of whom also had distal open surgical reconstructions.
Median follow-up was 16 months (range 1–60 months).
Results: Guidewire crossing of two aorto-biiliac occlusions failed, resulting in a 93% (28/30) technical success. Major complications
included one access hematoma, one myocardial infarction, one death (recurrent thromboembolism) in a patient with widespread
malignancy, and one fatal hemorrhage during thrombolysis of distal emboli from a recanalized occluded iliac artery. One patient
did not improve his symptoms, resulting in a 1-month clinical success of 83% (25/30). Following restenting the 26 stented
survivors changed their clinical limb status to +3 (n = 17) and +2 (n = 9). During follow-up one symptomatic aortic restenosis occurred and was successfully restented.
Conclusions: Primary stenting of complex aortic stenoses and short occlusions is an attractive alternative to conventional surgery. Larger
studies with longer follow-up and stratification of lesion morphology are warranted to define its role relative to balloon
angioplasty. Stenting of aorto-biiliac occlusions is feasible but its role relative to bypass grafting remains to be defined. 相似文献
6.
D. Liermann E. P. Strecker J. Peters 《Cardiovascular and interventional radiology》1992,15(5):298-305
We have implanted more than 100 Strecker stents in the iliac and femoral arteries. In iliac arteries, follow-up is available
from 8 to 48 months (mean 20 months) and in peripheral arteries, from 8 to 32 months (mean 19 months). In iliac and proximal
femoral arteries there was a patency rate of 98% (mean 20 months after stent implantation) whereas in peripheral arteries
the patency rate was 70.8% (mean 19 months after stent implantation). Besides careful selection of patients, anticoagulation
is very important for successful stenting. Because of the excellent results of stents in iliac vessels there is a wide range
of good indications, including primary stenting after recanalization of occlusions. In contrast, stent implantation in peripheral
vessels should be restricted to special cases such as acute dissection or reocclusion after successful recanalization. 相似文献
7.
Gary P. Siskin Brian F. Stainken Valerie S. Mandell R. Clement Darling Kyran Dowling Allen Herr 《Cardiovascular and interventional radiology》1999,22(5):375-380
Purpose: To evaluate the role of metallic stents in treating stenoses involving prosthetic arterial bypass grafts.
Methods: Patients undergoing stent placement within a failing prosthetic bypass graft, during a 41-month period, were reviewed for
treatment outcome and complications. The indications for stent placement in 15 patients included severe claudication (n= 3), rest pain (n= 9), and minor or major tissue loss (n= 3). Lesions were at the proximal anastomosis (n= 6), the distal anastomosis (n= 3), or within the graft (n= 6).
Results: Treatment with metallic stents was successful in all patients. There was one acute stent thrombosis, successfully treated
with thrombolytic therapy. Follow-up data are available for a mean duration of 12.3 months. The mean duration of primary patency
was 9.4 months with 6- and 12-month primary patency rates of 51.9% and 37.0%, respectively. The mean duration of secondary
patency was 12.1 months with 6- and 12-month secondary patency rates of 80.0% and 72.7%, respectively. Two patients with discontinuous
runoff and preexisting gangrene required a below-knee amputation. Six patients were revised surgically after stent placement
(at a mean of 10.8 months). Three late deaths occurred during follow-up.
Conclusion: Given the mortality risks of surgical revision and the reduced life expectancy of this patient population, metallic stent
placement represents a viable, short-term treatment option for stenoses within or at the anastomoses of prosthetic grafts.
Further evaluation is warranted to compare intragraft stent placement with surgical graft revision. 相似文献
8.
David J. Glickerman Peter B. Hathaway Thomas Hatsukami Charles P. Daly Sandra Althaus Ted R. Kohler 《Cardiovascular and interventional radiology》1997,20(6):466-469
This report describes the transluminal placement of a stent graft occlusion device to treat a celiac bypass graft pseudoaneurysm
which was causing biliary and duodenal obstruction.
Received: 0/00/00/Accepted: 0/00/00 相似文献
9.
Alexander Ruebben Serena Tettoni Pierluigi Muratore Dennis Rossato Daniele Savio Claudio Rabbia 《Cardiovascular and interventional radiology》1998,21(4):339-342
To evaluate the feasibility of percutaneous treatment of iliac aneurysms, a covered stent was inserted in nine men suffering
from common iliac artery aneurysms (six cases), external iliac aneurysms (one case), or pseudoaneurysms (two cases). Placement
of the stent was successful in all patients. In one patient, an endoprosthesis thrombosed after 15 days, but was successfully
treated by thrombolysis and additional stent placement. At the follow-up examinations (mean period 22 months) all stent-grafts
had remained patent. No late leakage or stenosis was observed. 相似文献
10.
Alexander Farber Mark-Michael Barbey Jens-Holger Grunert Ekkechardt Gmelin 《Cardiovascular and interventional radiology》1999,22(3):214-218
Purpose: To determine the effectiveness of using Dacron-covered stents to treat access-related venous stenoses and occlusions.
Methods: Twenty-two Dacron-covered stents were placed in 20 patients: in the basilic or axillary vein (n = 2), cephalic vein (n = 3), subclavian vein (n = 5), and at the venous anastomosis of the polytetrafluoroethylene (PTFE) implant graft (n = 10).
Results: Initial technical success was 100%. The cumulative primary and secondary patency rates were 57% and 83% at 6 months, 29%
and 64% at 12 months, and 29% and 53% at 18 months. A statistically significant difference in the stent patency was revealed
by comparing the patients with stents in the subclavian vein and patients with upper arm stents. The secondary patency rates
of the upper arm stents were 73% after 6, 12, and 18 months.
Conclusions: Percutaneous placement of Dacron-covered stents is a safe and effective procedure for salvage of a dialysis fistula. First
results are promising, with a tendency to prolongation of the time interval between reinterventions. 相似文献
11.
Karl Schürmann Dierk Vorwerk Arno Bücker Stefanie Grosskortenhaus Rolf W. Günther 《Cardiovascular and interventional radiology》1998,21(5):411-418
Purpose: To compare patency and neointima formation of single and tandem arterial stents.
Methods: In each of six sheep, two Memotherm nitinol stents (tandem stents) were inserted into the external iliac artery on one side
and a single stent into the artery on the opposite side. The size of the iliac lumen was assessed in the proximal, middle,
and distal segments of the stents by intravascular ultrasound (IVUS) before, immediately after, and 1 month after implantation
when the sheep were killed. Neointimal thickness was determined in the proximal, middle, and distal segments of each stent
by light microscopy.
Results: All stents remained patent. There was no significant difference in lumen and neointimal thickness between single and tandem
stents. Cranial tandem stents showed a significantly wider lumen and smaller neointimal thickness than caudal tandem stents.
In the proximal and distal segments, the lumen of the stents was significantly smaller and the neointimal thickness greater
than in the middle segment; differences in neointimal thickness were significant only between the proximal and the middle
segment.
Conclusion: In an experimental setting, tandem stents did not interfere with one another with regard to patency and neointima formation
when compared with a single contralateral stent. Neointimal thickening after stent insertion seems to be inversely related
to the original arterial diameter. 相似文献
12.
Balzer JO Gastinger V Thalhammer A Ritter RG Lindhoff-Last E Schmitz-Rixen T Vogl TJ 《European radiology》2006,16(2):381-390
We report the primary and mid-term outcome of patients with long chronic iliac artery occlusions after percutaneous excimer-laser-assisted interventional recanalization. Between 2000 and 2001, 43 patients with 46 chronic occlusions of either the common iliac artery (n=27), the external iliac artery ( n=13) or both (n=3) underwent laser-assisted percutaneous transluminal angioplasty and implantation of stents. The average length of the occlusion was 57.1±26 mm. After laser-assisted angioplasty and implantation of a total of 60 stents, the patients were followed up for up to 4 years. Patency rates were analyzed by ankle–brachial index (ABI) measurement and duplex ultrasound. The primary technical success rate was 95.3%, with a major complication rate of 6.9%. Clinical improvement as categorized by the Rutherford guidelines could be observed in 97.6% of cases. The ABI of all patients improved from an average of 0.46±0.08 before intervention to 0.97±0.13 at the end of the follow-up period. The overall primary patency rate was 86.1%. Four reinterventions were successful (secondary patency rate 95.4%). The mid-term results of the percutaneous recanalization of iliac artery occlusions with primary and secondary patency rates of 86.1 and 95.4% are similar to those of the treatment of short stenoses. 相似文献
13.
Ernst-Peter K. Strecker Irene B.L. Boos Dieter Göttmann Sylvia Vetter Wulf Haase 《Cardiovascular and interventional radiology》2001,24(3):168-175
Purpose: To evaluate the safety and efficacy of stent therapy for the treatment of residual stenoses after percutaneous transluminal
angioplasty (PTA) of popliteal stenoses and occlusions.
Methods: In a prospective single-center study, flexible tantalum stents were implanted in 32 popliteal arteries for the treatment
of residual stenosis greater than 50% after PTA of stenoses (n = 17) or occlusions (n = 15) in the P1 (n = 16), the P2 (n = 13), or both P1 and P2 segment (n = 3). Follow-up patency was assessed by clinical examination, ankle-brachial index, and color Doppler sonography or angiography.
Results: Early stent thrombosis (10 days): 1 of 32 arteries (3%). 1-year and 2-year primary patency rate (PPR): 81% ± 7.1% and 74%
± 9.1%, respectively. 1-year PPRs for subgroups: stented stenoses versus stented occlusions: 88% ± 7.8% vs 73% ± 12.0%, p = 0.12; good lower limb runoff versus poor: 84.0% ± 8.7% vs 76.0% ± 12.4; p = 0.09; P1 versus P2: 77.3% ± 9.8% vs 85.7% ± 9.4%, p = 0.38. Recurrent PTA lesions treated with stents showed higher restenosis rate than de novo lesions.
Conclusion: The results of stent therapy of residual popliteal stenosis after PTA are encouraging and warrant further investigation. 相似文献
14.
Relief of buttock claudication by percutaneous recanalization of an occluded superior gluteal artery
Senechal Q Auguste MC Louail B Lagneau P Pernes JM 《Cardiovascular and interventional radiology》2000,23(3):226-227
We report a case of a woman presenting with right severe buttock claudication and normal neurological and osteoarticular examination,
in whom a guidewire recanalization and percutaneous transluminal angioplasty (PTA) of an occluded right superior gluteal artery
(SGA) has provided relief of her symptoms. To our knowledge, this is the first report of percutaneous recanalization of the
SGA. PTA can be considered the treatment of choice for buttock claudication caused by SGA stenosis or occlusion. 相似文献
15.
Karl Schürmann Dierk Vorwerk Arno Bücker Jörg Neuerburg Stefanie Grosskortenhaus Patrick Haage Werner Piroth David W. Hunter Rolf W. Günther 《Cardiovascular and interventional radiology》1999,22(5):394-402
Purpose: To compare nonferromagnetic iliac artery prostheses in their suitability for patency monitoring with magnetic resonance angiography
(MRA) using conventional angiography as a reference.
Methods: In experiment 1, three Memotherm stents were inserted into the iliac arteries of each of six sheep: two “tandem” stents on
one side and a single stent on the other side. In experiment 2, four prostheses (normal and low-porosity Corvita stent-grafts,
Memotherm, ZA-stent) were inserted in each of 11 sheep. Patency was monitored before and 1, 3, and 6 months after insertion
with 3D phase-contrast and two 2D time-of-flight sequences (TOF-1: TR/TE = 18/6.9, TOF-2: 13/2.5) with and without contrast
at 1.5 T. On 206 coronal MIP images (72 pre-, 134 post-stenting), three readers analyzed 824 iliac segments (206 × 4) for
patency and artifacts.
Results: There was no difference in the number of artifacts between tandem and single iliac Memotherm stents. The ZA-stent induced
significantly fewer artifacts than the other prostheses (p < 0.00001). With MRA, patency of the ZA-stent was correctly diagnosed in 88% of cases, which was almost comparable to nonstented iliac
segments (95%), patency of the Memotherm stent in 59%, and of the Corvita stent-grafts in 57% and 55%. The TOF-2 sequence
with contrast yielded the best images.
Conclusion: MRA compatibility of nonferromagnetic prostheses depends strongly on the design of the device. MRA may be used to monitor
the patency of iliac ZA-stents, whereas iliac Memotherm stents and Corvita stent-grafts appear to be less suited for follow-up
with MRA. 相似文献
16.
Michael A. Braun M.D. Steven J. Smith Timothy N. Merrill 《Cardiovascular and interventional radiology》1996,19(6):428-430
We describe a technique that extracted a ruptured angioplasty balloon which had become entrapped by a calcified left common
iliac artery stenosis. The balloon catheter had been advanced crossover from the right and could not be retracted directly
into a sheath across the aortic bifurcation. Therefore, a guidewire was inserted through the balloon catheter and captured
by a loop snare advanced from the left femoral artery. The loop snare was also used to free the balloon wings from the stenosis.
The balloon was then pulled into a 10 Fr sheath and removed as a unit with the sheath. 相似文献
17.
Houston JG McCollum PT Stonebridge PA Raza Z Shaw JW 《Cardiovascular and interventional radiology》1999,22(2):89-95
PURPOSE: To assess the technical success, initial clinical outcome, and intermediate follow-up of the Memotherm nitinol self-expanding stent in aortic bifurcation reconstruction. METHODS: Thirty-three patients (13 male, 20 female), mean age 64 years, were treated, who had symptoms classified by the Surgical Vascular Society/International Society of Cardiovascular Surgery (SVS/ICVS) classification as grade 2 in 11 (33%), grade 3 in 19 (58%) and grade 4 in 3 (9%) patients. Lesions were classified according to severity and type. Indications for placement of a Memotherm nitinol self-expanding stent were failed angioplasty in 14 (42%), chronic occlusions in 12 (37%), and complex stenoses in seven (21%) patients. RESULTS: Sixty-seven stents were technically successfully placed in 66 aorto-iliac segments in 33 patients, with one major complication. Initial clinical outcome was improvement in 25 (81%), no change in four (13%), and a worsening in two (6%) patients by Rutherford criteria. Mean early ankle/brachial pressure index (ABI) gain was 0. 27 for occlusions and 0.05 for stenoses. Clinical follow-up was obtained in all patients, with retrospective angiographic follow-up in 28 (85%) at a mean of 16 months (range 12-26 months). The decrease in ABI and the decrease in angiographic luminal diameter at follow-up was determined as the "late loss." The mean ABI late losses were -0.06, 0.00, and 0.09, and the mean angiographic late losses were 6.7%, 10% and 14% for occlusions, stenoses, and normal segments respectively. Primary clinical patency was 96%, primary angiographic patency was 89%, and secondary angiographic patency was 93%. CONCLUSION: The high technical success of stent placement, the low complication rates for aortic bifurcation reconstruction using the Memotherm self-expanding stent, and high clinical and angiographic patency maintained at intermediate follow-up support their use in aortic bifurcation reconstruction. 相似文献
18.
Bertrand Janne d’Othée Hervé Rousseau Philippe Otal Francis Joffre 《Cardiovascular and interventional radiology》1999,22(5):424-427
We report a case of scapulothoracic dissociation with right subclavian artery traumatic injury that was managed by endovascular
treatment. Particular features are the use of a flexible self-expandable noncovered stent and simultaneous protection of the
right common carotid artery from distal embolization by inflating a balloon catheter. 相似文献
19.
Ernst-Peter K. Strecker M.D. Dieter Göttmann Irene B. L. Boos Sylvia Vetter 《Cardiovascular and interventional radiology》1998,21(5):375-379
Purpose: To examine the efficacy of the low-molecular-weight heparin, reviparin, for prevention of femoropopliteal stent restenosis.
Methods: Forty-two patients who had implantation of flexible tantalum stents for the treatment of stenosis (n= 24) or occlusion (n= 18) of the femoral (n= 27) or popliteal (n= 15) arteries were included in this study protocol. An intraarterial bolus of 5000 IU heparin was given before percutaneous
transluminal angioplasty (PTA), and in the case of stent implantation due to unsuccessful PTA, an additional dose of reviparin
(3500 anti-factor Xa IU) was given. Postprocedurally, 10,500 anti-factor Xa IU of reviparin were administered intravenously
over 24 hr, followed by 3500 anti-factor Xa IU subcutaneously twice a day for 23 days. Oral aspirin (100 mg/day) was prescribed
for the long term. Follow-up criteria (maximum follow-up 37 months) were clinical symptoms, Doppler ankle arm indices, color
and duplex sonography, and angiography for suspicion of restenosis.
Results: Early stent thromboses were not observed. Overall primary patency rate (PPR) was 88% ± 6.0% (1 year) and 74% ± 10.1% (2 years).
Major hemorrhagic complications have not occurred.
Conclusion: Reviparin administered in a high dose over a period of 24 days is a safe medication regimen and provides excellent patency
rates after stent implantation. 相似文献
20.
Jae-Kyu Kim Yun-Hyeon Kim Sang-Yeung Chung Heoung-Keun Kang 《Cardiovascular and interventional radiology》1999,22(4):278-281
Purpose: To report the clinical results for recanalizations of an occluded iliac artery by a self-expanding spiral stent.
Methods: We attempted to recanalize 36 iliac artery occlusions in 34 patients [33 men, 1 woman, aged 51–75 years (average 61.6 years)].
The average lesion length was 6.92 cm (range 1–14 cm). The patients' chief complaints were intermittent claudication and resting
pain. Fontaine classification was assigned before and after the procedure. Technical and clinical success were also analyzed.
Results: Forty-five stents were successfully deployed in 34 patients. All 36 lesions (13 in the external iliac artery, 12 in the common
iliac artery, and 11 in both) were patently recanalized on angiography. The follow-up period ranged from 6 months to 36 months
(mean 11.9 months). Fourteen stents (39%) with incomplete expansion were dilated with a balloon catheter. Good technical (100%)
and clinical (94%) results were obtained. The only complication was one hematoma at the puncture site. Reocclusions were noted
in two lesions (5%) at 1 week and 15 months, respectively.
Conclusion: A self-expanding spiral stent is a safe and effective device for recanalization of an iliac artery occlusion as the primary
stent without any previous intervention. 相似文献