Emergency stent-graft implantation for iatrogenic peripheral arterial rupture

作者：Xiao, L.^*; Shen, J.; Tong, J. -J.

来源：Radiologia Medica, 2013, 118(1): 152-157.

DOI：10.1007/s11547-012-0826-6

• Peripheral vascular disease
• Complication
• Endoluminal repair
• Stent-graft

We evaluated the experience with and efficacy of stent-grafting for iatrogenic peripheral arterial ruptures.
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 mmx60 mm or 8 mmx80 mm) under local anaesthesia.
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.
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.

• 出版日期2013-2
• 单位中国医科大学