title: Kissing iliac artery stent technique for salvage of a total occlusion of a jailed common iliac artery.
abstract: A 70-year-old female was admitted to our hospital due to claudication of the left leg. The patient was diagnosed with peripheral artery disease and received endovascular therapy (EVT) with a stent implanted in the right common iliac artery (CIA) at another hospital 3 months earlier. The left CIA was jailed by the stent. We performed EVT for the chronic total occlusion (CTO) of the jailed left CIA. A kissing-stent strategy was selected because the strut could not be fully opened. The wire was crossed through the stent strut, since passing the wire outside of the stent was problematic. A balloon was dilated at the stent strut and further inserted while dilated in order to create a space between the implanted stent and opposite aorta wall. Finally, a wire was successfully crossed outside of the stent in this space. A balloon-expandable stent was implanted at the aorta to left CIA in order to perform the kissing-stent technique. Additionally, a self-expandable stent was deployed at the left external iliac artery. To facilitate kissing-stent technique for a jailed CIA CTO lesion, inserting the balloon while inflated at the bifurcation was useful to create space for advancing the guidewire along the stent.
authors.affiliation: Division of Cardiovascular Medicine, Toyohashi Heart Center, 21-1 Gobudori, Oyama-cho, Toyohashi, 441- 8530, Japan. nasu@heart-center.or.jp.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ishizuka
authors.forename: Maoto
authors.initials: M
authors.lastname: Habara
authors.forename: Kenya
authors.initials: K
authors.lastname: Nasu
mesh_terms: D000368:Aged; D000792:Angiography; D000800:Angioplasty, Balloon / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016879:Salvage Therapy / Q000379:methods*; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome