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Published on: October 26, 2016
Looped Balloon-Expandable Covered Stents for Bailout Hemostasis of Iliac Artery Injury
Hiroshi Kawahara1, Yusuke Morita1, Hirotomo Sato1
1Division of Cardiology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.
Background:
Balloon-expandable covered stents (VIABAHN VBX) are commonly used for iatrogenic arterial injuries. However, the outcomes of their use in loop configurations remain unclear.
Case Summary:
A man in his 80s experienced severe iliac artery injury during endovascular repair of common and internal iliac artery aneurysms. Sequential implantation of 4 stent grafts in a loop configuration with balloon dilation achieved hemostasis. Rebleeding was successfully managed with implantation of an additional stent graft and balloon dilation.
Discussion:
Although junctional rebleeding should be recognized as a potential complication of looped stent grafts, it can be successfully managed. The patient remained asymptomatic with a preserved ankle-brachial pressure index at the 3-year follow-up.
Take-Home Message:
The loop configuration of balloon-expandable covered stents may provide an effective bailout strategy for severe arterial injuries.
