Endovascular treatment for visceral vessel complication after branched graft replacement: initial results.
OBJECTIVE
The objective of our study was to retrospectively assess the safety and efficacy of endovascular treatment for branch stenosis or obstruction after branched graft replacement in patients with thoracoabdominal aortic aneurysm or aortic arch aneurysm.


METHODS
Seven patients (all men; median age, 62 years; age range, 19-79 years) who had undergone aortic surgery using branched grafts between March 2004 and January 2007 were treated. Diagnosis was established on dynamic contrast-enhanced CT or angiography. A self- or balloon-expandable stent was placed after predilatation with a balloon catheter and, if necessary, thrombolysis was also performed. Stent patency was assessed on thin-slice axial images obtained during the arterial phase on dynamic contrast-enhanced CT.


RESULTS
Seven lesions (one celiac artery, two left subclavian arteries, and four renal arteries) were treated. The time between the surgery and treatment was 0-3 days for patients with abdominal lesions and 20-41 days for those with thoracic lesions. Stent placement was successful in five of the seven patients. In one patient, insertion of the stent delivery system was unsuccessful; in the other patient, the stent was not completely expanded. The clinical symptoms and abnormal laboratory data improved in all patients with successful procedures. No restenosis was observed on imaging follow-up, with a median patency of 104 days (range, 5-1,218 days) during clinical follow-up (range, 37-1,218 days; median, 135 days).


CONCLUSIONS
Endovascular repair can be an alternative treatment for visceral vessel complications of branched grafts, especially in obstructed but peripherally patent branches.
Kawasaki
Ryota
R
Department of Radiology, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. kawaryo1999@yahoo.co.jp
Sugimoto
Koji
K
Taniguchi
Takanori
T
Yamaguchi
Masato
M
Fujii
Masahiko
M
Sugimura
Kazuro
K
Okita
Yutaka
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D003287:Contrast Media; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency
D003287:Contrast Media