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

Year 2013, Volume: 10 Issue: 12, - , 21.03.2016

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.

References

  • Sawhney R, Allen D, Nanavati S. Kissing balloon-expand- able iliac stents complicated by stent fracture. J Vasc Interv Radiol 2008; 19:1519-1520
  • Ichihashi S, Higashiura W, Itoh H, Sakaguchi S, Kichikawa K. Fracture and Collapse of Balloon-Expandable Stents in the Bilateral Common Iliac Arteries Due to Shiatsu Massage. Cardiovasc Intervent Radiol Dec 23 2011
  • Palmaz JC, Laborde JC, Rivera FJ, Encarnacion CE, Lutz JD, Moss JG. Stenting of the iliac arteries with the Palmaz stent: experience from a multicenter trial. Cardiovasc Intervent Radiol 1992; 15:291-297
  • De Roeck A, Hendriks JM, Delrue F, et al. Long-term re- sults of primary stenting for long and complex iliac artery occlusions. Acta Chir Belg 2006; 106:187-192
  • Ozkan U, Oguzkurt L, Tercan F, Gumus B. Endovascular treatment strategies in aortoiliac occlusion. Cardiovasc Intervent Radiol 2009; 32:417-421
  • Leung DA, Spinosa DJ, Hagspiel KD, Angle JF, Matsumoto AH. Selection of stents for treating iliac arterial occlusive disease. J Vasc Interv Radiol 2003; 14:137-152
  • Grenacher L, Rohde S, Ganger E, Deutsch J, Kauffmann GW, Richter GM. In vitro comparison of self-expanding versus balloon-expandable stents in a human ex vivo model. Cardiovasc Intervent Radiol 2006; 29:249-254
  • Reekers JA, Vorwerk D, Rousseau H, et al. Results of a European multicentre iliac stent trial with a flexible bal- loon expandable stent. Eur J Vasc Endovasc Surg 2002; 24:511-515
  • Sacks BA, Miller A, Gottlieb M. Fracture of an iliac artery Palmaz stent. J Vasc Interv Radiol 1996; 7:53-55
  • Jaff M, Dake M, Pompa J, Ansel G, Yoder T. Standardized evaluation and reporting of stent fractures in clinical tri- als of noncoronary devices. Catheter Cardiovasc Interv 2007; 70:460-462
  • Stankiewicz JM, Robertson SW, Ritchie RO. Fatigue-crack growth properties of thin-walled superelastic austenitic Nitinol tube for endovascular stents. J Biomed Mater Res A. 2007; 81:685-691
  • Adlakha S, Sheikh M, Wu J, et al. Stent fracture in the coronary and peripheral arteries. J Interv Cardiol 2010; 23:411-419

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

Year 2013, Volume: 10 Issue: 12, - , 21.03.2016

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

References

  • Sawhney R, Allen D, Nanavati S. Kissing balloon-expand- able iliac stents complicated by stent fracture. J Vasc Interv Radiol 2008; 19:1519-1520
  • Ichihashi S, Higashiura W, Itoh H, Sakaguchi S, Kichikawa K. Fracture and Collapse of Balloon-Expandable Stents in the Bilateral Common Iliac Arteries Due to Shiatsu Massage. Cardiovasc Intervent Radiol Dec 23 2011
  • Palmaz JC, Laborde JC, Rivera FJ, Encarnacion CE, Lutz JD, Moss JG. Stenting of the iliac arteries with the Palmaz stent: experience from a multicenter trial. Cardiovasc Intervent Radiol 1992; 15:291-297
  • De Roeck A, Hendriks JM, Delrue F, et al. Long-term re- sults of primary stenting for long and complex iliac artery occlusions. Acta Chir Belg 2006; 106:187-192
  • Ozkan U, Oguzkurt L, Tercan F, Gumus B. Endovascular treatment strategies in aortoiliac occlusion. Cardiovasc Intervent Radiol 2009; 32:417-421
  • Leung DA, Spinosa DJ, Hagspiel KD, Angle JF, Matsumoto AH. Selection of stents for treating iliac arterial occlusive disease. J Vasc Interv Radiol 2003; 14:137-152
  • Grenacher L, Rohde S, Ganger E, Deutsch J, Kauffmann GW, Richter GM. In vitro comparison of self-expanding versus balloon-expandable stents in a human ex vivo model. Cardiovasc Intervent Radiol 2006; 29:249-254
  • Reekers JA, Vorwerk D, Rousseau H, et al. Results of a European multicentre iliac stent trial with a flexible bal- loon expandable stent. Eur J Vasc Endovasc Surg 2002; 24:511-515
  • Sacks BA, Miller A, Gottlieb M. Fracture of an iliac artery Palmaz stent. J Vasc Interv Radiol 1996; 7:53-55
  • Jaff M, Dake M, Pompa J, Ansel G, Yoder T. Standardized evaluation and reporting of stent fractures in clinical tri- als of noncoronary devices. Catheter Cardiovasc Interv 2007; 70:460-462
  • Stankiewicz JM, Robertson SW, Ritchie RO. Fatigue-crack growth properties of thin-walled superelastic austenitic Nitinol tube for endovascular stents. J Biomed Mater Res A. 2007; 81:685-691
  • Adlakha S, Sheikh M, Wu J, et al. Stent fracture in the coronary and peripheral arteries. J Interv Cardiol 2010; 23:411-419
There are 12 citations in total.

Details

Primary Language English
Journal Section Case Report
Authors

Fuat Özkan This is me

Bora Peynircioğlu This is me

Murat Canyigit This is me

Onur Ergun This is me

Barbaros Erhan Cil This is me

Saruhan Cekirge This is me

Publication Date March 21, 2016
Published in Issue Year 2013 Volume: 10 Issue: 12

Cite

APA Özkan, F., Peynircioğlu, B., Canyigit, M., Ergun, O., et al. (2016). Disintegration of a Balloon-Expandable Stent in the Iliac Artery upon Delivery: Successful Endovascular Management. European Journal of General Medicine, 10(12).
AMA Özkan F, Peynircioğlu B, Canyigit M, Ergun O, Cil BE, Cekirge S. Disintegration of a Balloon-Expandable Stent in the Iliac Artery upon Delivery: Successful Endovascular Management. European Journal of General Medicine. March 2016;10(12).
Chicago Özkan, Fuat, Bora Peynircioğlu, Murat Canyigit, Onur Ergun, Barbaros Erhan Cil, and Saruhan Cekirge. “Disintegration of a Balloon-Expandable Stent in the Iliac Artery Upon Delivery: Successful Endovascular Management”. European Journal of General Medicine 10, no. 12 (March 2016).
EndNote Özkan F, Peynircioğlu B, Canyigit M, Ergun O, Cil BE, Cekirge S (March 1, 2016) Disintegration of a Balloon-Expandable Stent in the Iliac Artery upon Delivery: Successful Endovascular Management. European Journal of General Medicine 10 12
IEEE F. Özkan, B. Peynircioğlu, M. Canyigit, O. Ergun, B. E. Cil, and S. Cekirge, “Disintegration of a Balloon-Expandable Stent in the Iliac Artery upon Delivery: Successful Endovascular Management”, European Journal of General Medicine, vol. 10, no. 12, 2016.
ISNAD Özkan, Fuat et al. “Disintegration of a Balloon-Expandable Stent in the Iliac Artery Upon Delivery: Successful Endovascular Management”. European Journal of General Medicine 10/12 (March 2016).
JAMA Özkan F, Peynircioğlu B, Canyigit M, Ergun O, Cil BE, Cekirge S. Disintegration of a Balloon-Expandable Stent in the Iliac Artery upon Delivery: Successful Endovascular Management. European Journal of General Medicine. 2016;10.
MLA Özkan, Fuat et al. “Disintegration of a Balloon-Expandable Stent in the Iliac Artery Upon Delivery: Successful Endovascular Management”. European Journal of General Medicine, vol. 10, no. 12, 2016.
Vancouver Özkan F, Peynircioğlu B, Canyigit M, Ergun O, Cil BE, Cekirge S. Disintegration of a Balloon-Expandable Stent in the Iliac Artery upon Delivery: Successful Endovascular Management. European Journal of General Medicine. 2016;10(12).