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[Percutaneous reconstruction of a pelvic vascular occlusion using the "kissing-balloon" technique]
H Krankenberg1, C Walther, I Sorge
1Universität Leipzig Herzzentrum Klinik für Kardiologie/Innere Medizin.
Insights
Laser-assisted recanalization effectively treated severe iliac artery occlusion, even at the aortoiliac bifurcation. This minimally invasive approach improved patient outcomes, avoiding the need for surgery.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Interventions
Background:
- Iliac artery occlusions, particularly those involving the aortoiliac bifurcation, pose significant challenges in vascular treatment.
- Severe claudication necessitates effective revascularization strategies to restore blood flow and improve patient mobility.
Observation:
- A 43-year-old patient presented with severe right leg claudication due to an occluded right common iliac artery.
- A successful endovascular intervention was performed using a cross-over approach, excimer laser recanalization, and kissing balloon angioplasty.
Findings:
- The kissing balloon technique facilitated primary stent implantation, protecting the aortoiliac bifurcation.
- Post-procedure, the patient experienced complete symptom resolution, confirmed by treadmill exercise testing and duplex sonography.
Implications:
- Laser-assisted recanalization combined with the kissing balloon technique offers a favorable alternative to more invasive treatments for complex iliac artery occlusions.
- This endovascular strategy can effectively avoid surgical intervention, reducing patient morbidity and recovery time.
Unlabelled:
A 43-year-old patient was admitted for severe claudication in his right leg, doppler ultrasound and angiography revealed an occluded right common iliac artery. Using the cross-over-approach from the contralateral side, it was possible to navigate a guide wire through the occlusion, and after passage with an excimer laser an ipsilateral retrograde puncture with placement of a sheath was performed. In order to protect the the aortoiliac bifurcation, a primary stent implantation of the occluded side was carried out using the kissing balloon technique. Afterwards three stents were placed. Subsequently the patient completely improved; treadmill exercise test and duplex sonography showed good results.
Conclusion:
Using the kissing balloon technique, laser-assisted recanalisation of iliac artery occlusions even involving the aortoiliac bifurcation compare favorable to other more invasive treatments. A surgical procedure can thus be avoided.