title: Emergency stent-graft implantation for iatrogenic peripheral arterial rupture.
abstract: OBJECTIVE
  We evaluated the experience with and efficacy of stent-grafting for iatrogenic peripheral arterial ruptures.
  
  
  METHODS
  From 2005 to 2009 we performed stent-grafting on four male patients (age 38-67 years) with iatrogenic peripheral arterial ruptures. In patient 1, grointissue necrosis followed a subcutaneous injection and led to femoral arterial rupture. Pseudoaneurysms ruptured in patients 2 and 3 who were undergoing femoral arteriotomy. Patient 1 experienced a ruptured carotid artery during neck surgery. Shock occurred in three of the four patients. Four patients underwent self-expanding stent-grafting (8 mm×60 mm or 8 mm×80 mm) under local anaesthesia.
  
  
  RESULTS
  Haemorrhages were controlled in all patients. No procedure-related complications occurred. Patient 1 died of lung metastases 13 months after stent-grafting. Follow-up examinations showed that the stent-graft remained patent in patients 1, 2 and 4, whereas stent occlusion occurred after 15 months in patient 3; in this case, a pseudoaneurysm proximal to the stent was identified, and although repeat stent-grafting successfully stopped the bleeding, the patient died of multiple organ failure 1 week later.
  
  
  CONCLUSIONS
  Emergency stent-grafting is a technically feasible and therapeutically effective modality for treating high-risk patients who experience iatrogenic peripheral arterial ruptures. The efficient treatment of hypotension and early endovascular intervention will improve the prognosis.
authors.affiliation: Department of Radiology, the First Hospital of China Medical University, 155 Nanjing North Road, Shenyang 110001, Liaoning, PR China. xiaoliangcmu@yahoo.com.cn
authors.forename: L
authors.initials: L
authors.lastname: Xiao
authors.forename: J
authors.initials: J
authors.lastname: Shen
authors.forename: J-J
authors.initials: JJ
authors.lastname: Tong
mesh_terms: D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D000792:Angiography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003287:Contrast Media; D004638:Emergency Treatment; D005263:Femoral Artery / Q000293:injuries*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D015607:Stents; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D003287:Contrast Media