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《European journal of radiology》1998,28(1):80-85
The purpose of this retrospective study was to evaluate the use of percutaneous transluminal angioplasty (PTA) and subsequent Strecker stent implantation for the treatment of chronic iliac artery occlusions. A total of 39 patients were subjected to this procedure. The occluded vessels were catheterized, dilated and subjected to stenting in all patients: the length of occlusion varied from 4.5 to 10.5 cm (mean 5.9), lesions were located in common iliac arteries (25), external iliac arteries (10) and in combinations of both (4). Twenty-five patients presented stage II according to Fontaine classification, nine patients stage III and five patients stage IV. The stent was mounted on balloon catheter and introduced through a 9 French sheet (for 8–10 mm stent diameter). After this procedure, 37 out of 39 patients showed a statistically significant increase in the Doppler sonographic ankle-arm index (AAI) (P=0.001) and improvement of clinical symptoms, while in two patients a complete occlusion resulted due to long dissection not covered by the stent in one case and to stent misplacement in the other case. After stenting, 27 patients improved to stage I, ten patients to stage IIa and two patients showed no changes. Two complications were observed: one groin hematoma and one distal embolization. At a 6-month follow-up, a 89.7% of patency was observed. This study shows that Strecker stent can be successfully employed in addition to PTA to treat occlusions of the iliac arteries. 相似文献
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Arun Kumar Gupta M.D. Kolathu Ravimandalam Vedula Rajani Kanth Rao Santhosh Joseph Madhavan Unni Abburu Srinivasa Rao Kurur Sankaran Neelkandhan 《Cardiovascular and interventional radiology》1993,16(3):165-177
Fifty-six occluded iliac arteries (mean length 6.1 cm; range 1–17 cm) in 50 patients were treated by percutaneous transluminal
angioplasty (PTA) or laser-assisted PTA (bilateral lesions in 6 patients). Twenty-seven patients (54%) were at high risk for
surgery. Patients were followed for a maximum period of 72 months (mean 23.12 months; median 20 months). The initial success
rate was 78.5% for arteries and 82% for patients. Laser-assisted PTA was attempted in 11 occluded arteries (19.64%) and was
successful in 4 arteries (7.14%). Conventional PTA was successful in 71.4% of arteries including all 7 arteries for which
laser-assisted PTA failed (76% of patients). PTA was unsuccessful in 12 arteries (21.43%). Urokinase was used before PTA in
I artery. The effect of PTA was evident clinically by relief of rest pain (66.66%), healing of ulcer (57%), increased claudication
distance or no claudication (79%) in limbs, and objectively, by improvement in ankle/arm index (AAI) (an increase of 0.16
to 0.91) and increased exercise tolerance. Continuous improvement in AAI was observed after PTA on follow-up in 9 limbs. One
patient died during follow-up. On follow-up, 3 arteries were occluded, 6 showed evidence of stenosis, and 1 showed fusiform
dilatation at the PTA site. The long-term results using the life-table method determined a 76% primary patency rate and 81%
secondary patency rate for 72 months. The overall patency including failures was 63%. Age of the patients (p=0.0169) and hypertension
(p=0.0015) significantly affected the long-term patency of the artery but not the initial success. The major complications
were arterial rupture in a repeat procedure in 1 artery, axillary artery thrombosis in 1, and distal thromboembolic occlusion
during PTA in 4, The long-term patency rates suggest that PTA of totally occluded iliac arteries is a safe and effective procedure
and provides a long-term benefit.
This paper was presented in part at the 6th Asian Oceanian Congress of Radiology, New Delhi, India, December 14–18, 1991 相似文献
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Stevo Duvnjak 《World journal of radiology》2016,8(3):275-280
Approximately 20%-40% of patients with abdominal aortic aneurysms can have unilateral or bilateral iliac artery aneurysms and/or ectasia. This influences and compromises the distal sealing zone during endovascular aneurysm repair. There are a few endovascular techniques that are used to treat these types of aneurysms, including intentional occlusion/over-stenting of the internal iliac artery on one or both sides, the “bell-bottom” technique, and the more recent method of using an iliac branch stent graft. In some cases, other options include the “snorkel and sandwich” technique and hybrid interventions. Pelvic ischemia, represented as buttock claudication, has been reported in 16%-55% of cases; this is followed by impotence, which has been described in 10%-17% of cases following internal iliac artery occlusion. The bell-bottom technique can be used for a common iliac artery up to 24 mm in diameter given that the largest diameter of the stent graft is 28 mm. There is a paucity of data and evidence regarding the “snorkel and sandwich” technique, which can be used in a few clinical scenarios. The hybrid intervention is comprised of a surgical operation, and is not purely endovascular. The newest branch stent graft technology enables preservation of the anterograde flow of important side branches. Technical success with the newest technique ranges from 85%-96.3%, and in some small series, technical success is 100%. Buttock claudication was reported in up to 4% of patients treated with a branch stent graft at 5-year follow-up. Mid- and short-term follow-up results showed branch patency of up to 88% during the 5-6-year period. Furthermore, branch graft occlusion is a potential complication, and it has been described to occur in 1.2%-11% of cases. Iliac branch stent graft placement represents a further development in endovascular medicine, and it has a high technical success rate without serious complications. 相似文献
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PURPOSETo demonstrate the efficacy of carotid duplex ultrasound to diagnose common carotid artery occlusion (CCAO) and to define the clinical features of CCAO.METHODSWe reviewed 5400 carotid duplex ultrasonograms obtained over a 7-year period for suspected carotid artery disease. In cases of CCAO, medical records were reviewed.RESULTSThirteen cases (0.24%) of CCAO were diagnosed by carotid duplex ultrasonography, including five cases of isolated CCAO. Seven cases were proved by cerebral angiography. Cerebral angiography failed to demonstrate patent internal carotid arteries in two cases of isolated CCAO. Mean age of onset was 67 +/- 9 years. The main clinical presentation was stroke in nine cases (69%). The most common vascular risk factors were hypertension (62%) and heart diseases (54%). Three patients had a history of radiation therapy to the neck. Two of five patients with isolated CCAO had major stroke, with good recovery in one, whereas five of eight patients with CCAO had major stroke; among them, only one had good recovery.CONCLUSIONPatients with isolated CCAO may have a better outcome than patients with CCAO. Duplex sonography, particularly with color-coded flow imaging, provides an accurate examination to define the patency of the arteries distal to the carotid bifurcation. The clinical features of CCAO are similar to those of internal carotid artery occlusion except for the low prevalence of CCAO. 相似文献
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A case of acute renal artery thrombosis superimposed on a stenotic atheromatous lesion treated with low-dose streptokinase thrombolysis and percutaneous transluminal angioplasty is presented. Renal function was promptly improved. This combined approach is recommended in selected elderly and seriously ill patients. 相似文献
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Jonathan Adler M.D. Ibrahim M. Ibrahim Michael Goldman David F. Thomashow 《Urologic radiology》1983,5(1):113-116
A case of acute renal artery thrombosis superimposed on a stenotic atheromatous lesion treated with low-dose streptokinase thrombolysis and percutaneous transluminal angioplasty is presented. Renal function was promptly improved. This combined approach is recommended in selected elderly and seriously ill patients. 相似文献
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Neal Joseph M.D. Elliot Levy Steven Lipman 《Cardiovascular and interventional radiology》1987,10(5):276-279
A case of nonsurgical treatment of common iliac artery rupture secondary to percutaneous transluminal angioplasty is reported. 相似文献
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【摘要】 目的 比较双侧髂内动脉球囊阻断术和双侧髂总动脉球囊阻断术在凶险性前置胎盘剖宫产术中应用的临床效果。方法 回顾性分析2017年9月至2019年2月于徐州医科大学附属医院住院剖宫产分娩的64例凶险性前置胎盘产妇的临床资料。根据剖宫产术前介入术式不同,分为双侧髂内动脉球囊临时阻断术组(A组,n=45)和双侧髂总动脉球临时囊阻断术组(B组,n=19)。观察记录和比较两组剖宫产手术时间、透视时间、术中出血量和输血量、子宫切除率、术后住院时间、新生儿Apgar评分及手术相关并发症。结果 两组介入手术均获得成功。A组、B组平均透视时间分别为(194.58±77.41) s、(77.62±51.51) s,术中出血量分别为(1 522.22±831.18) mL、(1 042.11±478.79) mL,术中输血量分别为(986.67±739.04) mL、(715.79±433.67) mL,差异均有统计学意义(P<0.05);两组剖宫产手术时间、新生儿Apgar评分、术后住院时间、子宫切除率差异均无统计学意义(P>0.05)。 结论 两种介入球囊阻断术均可有效减少凶险性前置胎盘产妇剖宫产术中出血量,双侧髂总动脉球囊阻断术操作更简单,且剖宫产术中透视时间和出血量更少,临床应用中更具有优势。 相似文献
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Mofidi R Macaskill EJ Griffiths GD Chakraverty S;East of Scotland Vascular Network 《Cardiovascular and interventional radiology》2008,31(Z2):S45-S47
Persistent sciatic artery is a rare congenital anomaly. It is associated with increased incidence of aneurysmal dilatation, thrombosis, distal embolization, and atherosclerotic change. We describe the case of a patient with persistent sciatic artery who presented with a critically ischemic left leg as a result of an occluded left common iliac artery, which was treated by angioplasty and stenting, and discuss the endovascular iliac recanalization in the presence of a persistent sciatic artery. 相似文献
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To recanalize occlusions of the iliac artery from an ipsilateral approach, the authors developed a technique in which the guide wire is manipulated through puncture sites in both sides of the groin. This technique was used in four occlusions (three in the common iliac artery and one in the external iliac artery); all occlusions were successfully dilated with balloon catheters. In two cases in which dilation was performed from the contralateral side, the contralateral iliac artery became occluded after the procedure. These occlusions were successfully dilated. 相似文献
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Kobayashi N Miyachi S Hattori K Tanasawa T Okada T Endo O Yamamoto N 《Neuroradiology》2006,48(11):847-851
Introduction Carotid angioplasty with stenting (CAS) is becoming accepted as an effective and reliable treatment option for severe carotid artery stenosis. However, it is rarely applied for carotid occlusion, especially in its chronic stage. We report our experience of CAS for chronic internal carotid artery occlusion representing compromised cerebral blood flow using various protection methods.Methods A 77-year-old woman, who was already diagnosed with severe left internal carotid artery stenosis, suddenly had right hemiparesis and aphasia. At that time, she was treated conservatively because her neurological status was quite good, in spite of left carotid artery occlusion. Her symptoms improved in the short term, except slight aphasia, but deteriorated again 18 days from the onset, and magnetic resonance imaging (MRI) showed new ischemic lesions. CAS was then performed for the occluded carotid artery on the 23rd day from the first onset.Results Using the proximal protection technique, the occluded lesion was crossed carefully with a microguidewire. Stents were also placed successfully with the distal protection technique. The occluded carotid artery was completely recanalized without any unfavorable events or neurological deterioration.Conclusion In this patient, CAS was successfully to treat chronic carotid artery occlusion. These procedures and techniques are reviewed and discussed. 相似文献
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Roland Watura Shaun F. S. Halpin Michael S. T. Ruttley 《Cardiovascular and interventional radiology》1995,18(6):396-398
A middle-aged woman presented with recent-onset left hemiparesis and right subclavian steal syndrome. She was found to have an obstructed innominate artery. We successfully performed balloon angioplasty of the occluded innominate artery and encountered no complications during follow-up of currently 8 months. 相似文献
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