Placement of a PTFE-covered Wallstent through a 12 Fr sheath for the exclusion of a common iliac artery aneurysm

The utility of endovascular stents in the treatment of blunt arterial injuries

BACKGROUND

The objective of this review is to evaluate our institutional experience with percutaneously placed vascular stents in multiply injured patients with blunt arterial injuries.

METHODS

Patients were identified through our trauma registry from 9/95 through 12/99. All injuries were diagnosed by angiography. Palmaz and Wallstent prostheses were used.

RESULTS

Six patients had blunt arterial injuries. Age ranged from 20 to 67 years (average, 45). Each patient had one or more stents placed. There were no immediate complications related to stent placement. There were no deaths or complications attributable to stent placement. All of the patients survived to leave the hospital. Follow-up ranged from 1 month to 2 years with no occlusion, stenosis, or stent malfunction.

CONCLUSION

The use of interventional angiography and endovascular stenting is safe and efficacious in treating arterial injuries in certain circumstances.

Covered stent implantation by the puncture method for the treatment of a small aneurysm of the common iliac artery

A method to repair endovascular aneurysms with covered stents has recently been developed. In the present paper, the implantation of a covered stent through a 12Fr sheath by the puncture method for the treatment of an isolated aneurysm of the right common iliac artery is reported. The aneurysm was less than 3 cm in diameter, and computed tomography showed no signs of aneurysm rupture, but the patient nonetheless complained of right lower abdominal pain and constipation. It was decided to implant a covered stent in lieu of surgical repair because it was difficult to prove a causal relationship between the aneurysm and the patient's complaints. Fortunately, after implantation, the symptoms were resolved. In conclusion, it is possible to choose this less invasive type of therapy for the treatment of an isolated iliac artery aneurysm if the patient complains only of general malaise and there are no certain signs of an impending rupture, although surgery should be indicated regardless of aneurysm size.