How should we manage thrombosis of Viabahn stent-graft? A case report focused on catheter-directed thrombolysis.

Autor: Kang WY; Section Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC., Campia U; Section Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC., Bernardo NL; Section Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC., Didier RJ; Section Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC., Negi SI; Section Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC., Kiramijyan S; Section Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC., Koifman E; Section Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC., Baker NC; Section Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC., Lipinski MJ; Section Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC., Escarcega RO; Section Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC., Torguson R; Section Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC., Waksman R; Section Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC. Electronic address: ron.waksman@medstar.net.
Jazyk: angličtina
Zdroj: Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2016 Mar; Vol. 17 (2), pp. 134-7. Date of Electronic Publication: 2016 Jan 28.
DOI: 10.1016/j.carrev.2016.01.011
Abstrakt: Purpose: To report a case of a thrombosed GORE® VIABAHN® endoprosthesis stent-graft in the femoral artery (SFA) and popliteal artery managed using the pulse-spray technique and complicated by compartment syndrome of the lower leg of the affected limb.
Case Report: A 61-year-old woman with three Viabahn stent grafts relining seven bare-metal stents in her right SFA and popliteal artery visited our hospital with complaint of recurrent lifestyle-limiting claudication of right leg. Angiography and intravascular ultrasound showed complete intra-stent obstruction by thrombus from the proximal right SFA to the proximal popliteal artery. Catheter-directed thrombolysis using pulse-spray technique followed by mechanical thrombectomy was performed. Despite successful recanalization, unfortunately, compartment syndrome developed on her right leg on the following day and fasciotomy was performed.
Conclusion: The larger thrombus burden in Viabahn stent-grafts and its unique physicochemical properties increases the risk for distal embolic complications and potential poor clinical outcomes.
(Copyright © 2016 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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