Emergency management of iatrogenic arterial injuries with a low-profile balloon-expandable stent-graft: Preliminary results. Issue 15 (April 2020)

• Record Type: Journal Article
• Authors: Ruffino, Maria Antonella; Fronda, Marco; Varello, Sara; Discalzi, Andrea; Mancini, Andrea; Muratore, Pierluigi; Rossato, Denis; Bergamasco, Laura; Righi, Dorico; Fonio, Paolo
• Other Names: Yin. Kanhua section editor.
• Is Part Of: Medicine. Volume 99:Issue 15(2020)
• Publication Date: 2020-04
• Subjects: arterial injury -- arterial rupture -- bleeding -- covered stent -- dissection -- pseudoaneurysm -- stent-graft -- vessel injury; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000019655
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: Endovascular treatment of arterial injuries with stent-graft is a reliable alternative approach in patients not suitable for embolization or at high risk for surgery. The aim of our study was to evaluate the efficacy and the safety of the BeGraft stent-graft, a low-profile balloon expandable covered stent, for emergency endovascular treatment of iatrogenic arterial injuries. Between August 2015 and September 2018, 34 consecutive patients (mean age 71 ± 12 years, 9 females) underwent implantation of BeGraft stent-grafts for iatrogenic arterial injuries (22 active bleedings, 11 pseudoaneurysms, and 1 enteric-iliac fistula). The primary endpoints were technical and clinical success and rates of major and minor complications. The secondary endpoint was the patency of the device during the follow-up. Imaging follow-up was performed by duplex ultrasound and/or computed tomography angiography (according to lesion site/target vessel), at 1-6-12-15 and 24 months. In all 34 patients (100%), the lesion or the defect was effectively excluded with a cumulative amount of 42 stent-grafts. The clinical success was documented in 30/34 patients (88.2%). Neither device- or procedure-related deaths, or major complications occurred. A minor complication was reported in 1 patient (2.9%), successfully treated during the same procedure. Thirty (88.2%) patients were available for a mean follow-up time of 390 ± 168 days (minimum 184, maximum 770), with no observed loss of patency, yielding a 100% Kaplan–Meier cumulative survival patency function. The percentage of patent patients was 30/30 at 6 months, 22/22 at 12 months, and 5/5 at 15 months. Endovascular treatment of iatrogenic arterial injuries with the BeGraft stent-graft is minimally invasive and effective, with good patency rate at midterm follow-up. Abstract : Supplemental Digital Content is available in the text