title: Multiple overlapping bare stents for endovascular visceral aneurysm repair: a potential alternative endovascular strategy to multilayer stents.
abstract: BACKGROUND
  Multilayer stent has become a new endovascular strategy for visceral artery aneurysm repair. However, its use was not allowed in some areas, such as China. This study evaluates an alternative method: multiple overlapping bare stents for repairing visceral artery aneurysms.
  
  
  METHODS
  Twenty-four patients with celiac artery aneurysm (n = 2), splenic artery aneurysm (n = 8), hepatic artery aneurysm (n = 3), superior mesenteric artery aneurysm (n = 6), and renal artery aneurysm (n = 5) were treated with 2 to 4 overlapping bare stents. Long-term results, including clinical achievement ratio and target artery patency, were followed up with computed tomographic angiography.
  
  
  RESULTS
  Insertion of overlapping bare stents was successful in all patients. Five aneurysms (21%) were totally excluded 3 months after operation, increasing to 12 (50%) and 20 (83%) aneurysms with total isolation at 6 and 12 months' follow-up, respectively. The clinical achievement ratios of multiple overlapping bare stents on splenic artery aneurysms, hepatic artery aneurysms, renal artery aneurysms, celiac artery aneurysms, and superior mesenteric artery aneurysms were 75%, 100%, 80%, 50%, and 100%, respectively. All cases combined had 100% target artery patency.
  
  
  CONCLUSIONS
  Preliminary experience showed that repair using multiple overlapping bare stents seemed to be a potential alternative strategy for treating visceral artery aneurysm, resulting in target artery patency. However, the exact mechanism requires further study and more cases should be involved.
authors.affiliation: Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, P.R. China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Cun-ping
authors.initials: CP
authors.lastname: Yin
authors.forename: Hai-yan
authors.initials: HY
authors.lastname: Li
authors.forename: Jun-min
authors.initials: JM
authors.lastname: Bao
authors.forename: Zhi-qing
authors.initials: ZQ
authors.lastname: Zhao
authors.forename: Le-feng
authors.initials: LF
authors.lastname: Qu
authors.forename: Xiang
authors.initials: X
authors.lastname: Feng
authors.forename: Rui
authors.initials: R
authors.lastname: Feng
authors.forename: Qing-sheng
authors.initials: QS
authors.lastname: Lu
authors.forename: Zai-ping
authors.initials: ZP
authors.lastname: Jing
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D015901:Angiography, Digital Subtraction; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D014781:Viscera / Q000098:blood supply*