Endovascular stenting for stenoses in surgically reconstructed brachiocephalic bypass grafts: immediate and midterm outcomes.
OBJECTIVE
To report the use of endovascular stenting for treatment of patients with symptomatic obstruction of brachiocephalic surgical reconstructions.


METHODS
Twenty-two patients (17 men; mean age 65+/-6 years) with 24 symptomatic obstructions of brachiocephalic Dacron bypass grafts (2 aorto-innominate, 9 subclavian-carotid, and 11 carotid-subclavian) were treated with balloon-expandable stents delivered via a percutaneous brachial access or surgical exposure of the common carotid artery. A distal protection device was utilized in the 9 patients with subclavian-carotid bypass grafts. All patients were followed by clinical and Doppler examinations.


RESULTS
Procedural success was 100%; 1 (4.5%) patient developed transient intraprocedural aphasia owing to intolerance to the distal protection balloon occlusion. All 22 patients reported complete relief of their presenting symptoms. Over a 29-month follow-up, 3 (13.6%) restenoses were found, but none was due to stent compression.


CONCLUSIONS
Stenting for obstructed brachiocephalic reconstructions appears to be a safe, effective, and durable therapeutic strategy.
Anzuini
Angelo
A
University of Texas Medical Branch, Galveston, USA.
Chiesa
Roberto
R
Vivekananthan
Krishnamoorthy
K
Uretsky
Barry
B
Colombo
Antonio
A
Margonato
Alberto
A
Airoldi
Flavio
F
Rosanio
Salvatore
S
Augello
Giuseppe
G
Birnbaum
Yochai
Y
Magnani
Giuseppe
G
Esposito
Gloria
G
Melissano
Germano
G
Moura
Marcelo R L
MR
Briguori
Carlo
C
D000368:Aged; D000714:Anastomosis, Surgical; D000800:Angioplasty, Balloon; D001027:Aortography; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D012008:Recurrence; D015607:Stents; D016896:Treatment Outcome
D011093:Polyethylene Terephthalates