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Aortoiliac reconstruction in the setting of in-stent restenosis
H S Natraj Setty1, T R Raghu1, B C Srinivas1
1Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
Insights
Complex iliac artery obstructions pose surgical risks. A minimally invasive kissing balloon technique for stent implantation successfully treated bilateral lower limb ischemia in a peripheral artery disease patient, offering a safer alternative.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Peripheral Artery Disease Management
Background:
- Complex iliac artery obstructions, including bilateral stenosis and occlusions, are typically managed with aortofemoral bypass surgery.
- Surgical intervention carries significant risks, including a 3% mortality rate and potential morbidities like intestinal ischemia and neurological damage.
Abstract:
Complex iliac artery obstructions, particularly bilateral stenosis or total iliac artery occlusions, are usually treated with aortofemoral or aortobifemoral graft surgery. However, surgical treatment is associated with 3% mortality rate and significant morbidity such as intestinal ischemia, spinal cord injury, and ureteral damage. Percutaneous interventions of aortic bifurcation offer a promising alternative to surgery with potentially lower morbidity and mortality risk. We report a case of peripheral artery disease who had underwent right transfemoral iliac angioplasty with femoropopliteal bypass presented again with bilateral lower limb ischemia, who was successfully treated with stent implantation with the kissing balloon technique.
