Disintegration of a Balloon-Expandable Stent in the Iliac Artery upon Delivery: Successful Endovascular Management

Abstract

Although there are still some controversies on the choice of ideal stent as well as balloon-expandable versus self-expanding stents for aorto-iliac disease; iliac stenting is widely accepted procedure for focal atherosclerotic iliac artery stenosis. Herein, we present an unusual unilateral iliac stenting complication caused by disintegration struts of balloon-expandable stent which was successfully handled by means of kissing stents. 62-year-old woman presented with complaints of severe claudication of the right lower extremity. Short segment stenosis of the proximal right common iliac artery was detected. Balloon-expandable stent was deployed and stent delivery catheter was then exchanged uneventfully for the pigtail catheter followed by a control arteriogram which demonstrated the fractured and elongated stent into the distal aorta centrally. Then, two self-expandable nitinol stents were deployed in bilateral common iliac artery in order to compress the fractured stent struts against the aortic wall. Control arteriogram was obtained showing excellent result with no residual stenosis. However, stent fractures involving balloon-expandable stents in the iliac arteries are extremely rare, this unusual stent fracture type should be considered before implantation of a stent in the iliac artery.

Keywords

• Complications, stents, iliac artery

Disintegration of a Balloon-Expandable Stent in the Iliac Artery upon Delivery: Successful Endovascular Management

Abstract

İlyak stentleme, fokal aterosklerotik ilyak arter stenoz tedavisinde kabul edilen tedavi yöntemi olmakla birlikte stent seçimi önemli rol oynamaktadır. Bu olguda nadir bir ilyak stent komplikasyonu olan balon ile genişleyebilen stent strutlarının bozunmasının kissing stent tekniği ile tedavisini sunuyoruz. Sağ bacağında şiddetli kladikasyo şikayeti olan 62 yaşındaki hastanın yapılan tetkiklerinde proksimal sağ ana ilyak arterde kısa segment darlık saptandı. Sorunsuz yerleştirilen balon ile genişleyebilen stent sonrası elde olunan kontrol anjiografilerde stentin strutlarının dağılarak stent boyunun uzadığı distal aortaya doğru yer değiştirdiği görüldü. Bunun üzerine strutları damar duvarına yaslamak için kissing tekniği ile bilateral kendiliğinden genişleyen nitinol stent yerleştirildi. Kontrol anjiografide rezidüel stenoz saptanmadı. Sonuç olarak ilyak arter stentlemede bu tip nadir komplikasyonlar göz önünde bulundurulmalıdır

Keywords

• Komplikasyon, stent, ilyak arter

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