Emergency stent-graft implantation for iatrogenic peripheral arterial rupture |
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Authors: | L. Xiao J. Shen J. -J. Tong |
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Affiliation: | 1. Department of Radiology, the First Hospital of China Medical University, 155 Nanjing North Road, Shenyang, 110001, Liaoning, P.R. China
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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. |
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