Kissing balloon and stenting of ostial right and left common iliac artery lesions

Year 2010, Volume: 17 Issue: 2, - , 30.06.2010

Nuri Akkuş

Abstract

Dear Editor,
A 77-year-old white male presented with symptoms of claudication had ankle brachial indices (ABI) in the range of 0.5 bilaterally at rest. A peripheral angiogram by accessing right groin was done which revealed ostial 80-90% lesion in the right common iliac artery and 90-95% lesion in the left common iliac artery (Figure 1). The left femoral artery was punctured, and a sheath was advanced. Both lesions were wired with a stiff glidewire. A 5mm x 4 cm balloon was advanced and simultaneous kissing balloon inflation was done in both ostia of the common iliac arteries. Post inflation there was about 50% residual. A 7 x 27 mm Express stent advanced to the right common iliac artery lesion and a 7 x 23 mm Genesis stent was advanced to the left common iliac artery lesion. Simultaneous deployment of the stents was done at 6 atmospheres. A 9 x 2 cm balloon used to post-dilate the left common iliac stent with a good result (Figure 2). Patient had total relief of symptoms. As seen in this patient, ABI's below 0.5 correlate with severe anatomical lesions (1).

Key words: Peripheral artery disease, kissing balloon, stenting

Keywords

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Kissing balloon and stenting of ostial right and left common iliac artery lesions

Abstract

Dear Editor,
A 77-year-old white male presented with symptoms of claudication had ankle brachial indices (ABI) in the
range of 0.5 bilaterally at rest. A lower extremity angiogram by accessing right groin was done which revealed
ostial 90-95% lesion in the right common iliac artery and 80-90% lesion in the left common iliac artery (Figure
1). The left femoral artery was punctured, and a sheath was advanced. Both lesions were wired with a stiff
glidewire. A 5mm x 4 cm balloon was advanced and simultaneous kissing balloon inflation was done in
both ostia of the common iliac arteries. Post inflation there was about 50% residual. A 7 x 27 mm balloon
expandable stent advanced to the right common iliac artery lesion and a 7 x 23 mm balloon expandable stent
was advanced to the left common iliac artery lesion. Simultaneous deployment of the stents was done at 6
atmospheres. A 9 x 2 cm balloon used to post-dilate the left common iliac stent with a good result (Figure
2). Patient had total relief of symptoms. As seen in this patient, ABIs below 0.5 correlate with severe
anatomical lesions (1).

Keywords

Peripheral artery disease, kissing balloon, stenting

References

• Becker GJ, McClenny TE, Kovacs ME, et al. The importance of increasing public and physician awareness of peripheral arterial disease. J Vasc Interv Radiol 2001.