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Intravascular ultrasound-guided stenting for chronic abdominal aortic dissection
Rocco Giudice1, Antonio Frezzotti, Marco Scoccianti
1Division of Vascular Surgery, Endovascular Surgery Unit, S Giovanni-Addolorata Hospital Complex, Rome, Italy.
Purpose:
To describe how the combined use of duplex and intravascular ultrasound (IVUS) can assist in the evaluation and treatment of isolated abdominal aortic dissection without need for contrast angiography.
Case Report:
A 78-year-old man presented with intermittent bilateral buttock and thigh claudication. Duplex ultrasound and contrast-enhanced computed tomography (CT) confirmed a chronic dissection along 3 to 4 cm of the infrarenal abdominal aorta. During Extra Large Palmaz stent implantation, the procedure was based on IVUS images and fluoroscopy without angiography. Both duplex and IVUS images were critical in assessing the type and extent of the lesion to be treated, in guiding the procedure, and in assessing its satisfactory outcome.
Conclusions:
In selected cases, ultrasound-based imaging modalities can provide most of the information required to accomplish complex aortic procedures.