Treatment of catheter-induced iliac artery injuries with self-expanding endografts.
OBJECTIVE
To evaluate the efficacy of fabric-covered endoprostheses for percutaneous repair of traumatic iliac artery lesions.


METHODS
Among 47 patients treated for catheter-induced iliac artery injuries, 20 (42%) patients (13 men; mean age 58 +/- 10 years, range 41-76) presented with acute (n = 7) or subacute (n = 13) lesions considered inappropriate for bare stent implantation (17 dissecting aneurysms, 2 perforations, and 1 traumatic arteriovenous fistula). The self-expanding Cragg EndoPro System I or Passager devices were deployed percutaneously to exclude the defects.


RESULTS
Immediate exclusion of the lesion was achieved in all 20 cases; there were no major procedural complications. However, within 24 hours after implantation, fever (n = 11, 55%) and elevations in white blood cell count (n = 10, 50%) and C-reactive protein (n = 13, 65%) were seen in the majority of patients, which prolonged hospitalization in this group (8.4 versus 4.2 days). During a median 21-month follow-up (range 5-31), 2 angiographically documented restenoses at the outlet of the endografts were treated successfully with balloon angioplasty, achieving primary and secondary patency rates of 87% and 100%, respectively.


CONCLUSIONS
Early model stent-grafts provided a safe and effective endovascular treatment for iliac perforations and large arterial dissections, showing a high mid-term patency rate. However, postimplantation syndrome appears to occur frequently with this type of Dacron-covered nitinol device.
Scheinert
D
D
Department of Medicine II, University of Erlangen-Nürnberg, Germany. dierk.scheinert@gmx.de
Ludwig
J
J
Steinkamp
H J
HJ
Schröder
M
M
Balzer
J O
JO
Biamino
G
G
D000328:Adult; D000368:Aged; D000792:Angiography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D020099:Coated Materials, Biocompatible; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011474:Prosthesis Design; D012189:Retrospective Studies; D012421:Rupture; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery
D020099:Coated Materials, Biocompatible; D011093:Polyethylene Terephthalates