Case Reports
doi: 10.4103/0976-9668.198347.Aortoiliac reconstruction in the setting of in-stent restenosis
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- PMID:28250690
- PMCID: PMC5320816
- DOI: 10.4103/0976-9668.198347
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Case Reports
Aortoiliac reconstruction in the setting of in-stent restenosis
H S Natraj Setty et al. J Nat Sci Biol Med.2017 Jan-Jun.
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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.
Keywords: Angioplasty; aortob ifemoral graft surgery; iliac artery stenosis; in-stent restenosis.
Conflict of interest statement
There are no conflicts of interest.
Figures
Peripheral angiogram shows right common iliac artery stenosis of 90% at proximal and distal edges of the stent (a), right femoropolpiteal graft is thrombosed, left common iliac artery shows multifocal areas of narrowing and occlusion of 90% (b)
Terumo wire (0.035) and exteriorized through left femoral artery (a). Right femoral artery approach was used for deploying right common iliac artery stent. 8 mm × 55 mm peripheral balloon was used and serial predilatation done (b)
8 mm × 120 mm medtronic self-.expanding stent was deployed in the right common iliac artery and 7 mm × 150 mm medtronic self-expanding stent deployed in the left common iliac artery. Postdilatation with simultaneous kissing at aortoiliac junction was done using 8 mm × 55 mm balloon in right common iliac artery and 7 mm × 40 mm balloon in left common iliac artery. Postprocedure showed good distal flow
Computed tomography peripheral angiogram shows patent stent seen in relation to distal aorta, left common iliac artery, external right common iliac artery
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