[Percutaneous therapy of catheter-induced traumatic vascular lesions with Dacron coated nitinol stents]

Percutaneous peripheral interventional procedures as well as coronary interventions can be complicated by dissections and traumatic lesions of peripheral arteries. The aim of this study was to evaluate the efficacy of fabric covered endoprostheses for percutaneous repair of traumatic peripheral arterial lesions.

In this study we used the EndoPro 1/Passager device (Boston Scientific, USA), which is a self-expanding nitinol stent covered by an ultrathin layer of dacron fabric. In 27 patients a total number of 31 endoprostheses (mean length 7.3 cm) were implanted in iliac (n = 20), femoral (n = 6) and popliteal arteries (n = 1). Indications for stenting were large dissections (n = 24), arterial perforations (n = 2) and one traumatic arterio-venous fistula.

An immediate exclusion of the lesion could be achieved in all cases. There were no major procedural complications. However, within 24 hours after implantation 14 patients (51.9%) developed fever. WBC and CRP were elevated in 13 (48.1%) and 17 (63%) patients, respectively. Repeated blood cultures could not show any bacterial growth. The primary patency after a mean follow-up of 19 (5 to 31) months was 85.2%. In two cases with markedly impaired peripheral run-off subacute graft occlusions occurred. In 2 other cases the angiography revealed relevant restenoses (> 75%). The patency could be restored in 2 of these 4 cases leading to a secondary patency rate of 92.6%.

The EndoPro 1/Passager endoprosthesis seems to be safe and effective to seal large dissections and traumatic lesions of peripheral arteries, showing a high long-term patency rate.