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

Autor: Romain Didier, Smita I. Negi, Ron Waksman, Umberto Campia, Ricardo O. Escarcega, Edward Koifman, Rebecca Torguson, Won Yu Kang, Nevin C. Baker, Michael J. Lipinski, Nelson L. Bernardo, Sarkis Kiramijyan
Rok vydání: 2016
Předmět:
medicine.medical_specialty
medicine.medical_treatment
Femoral artery
030204 cardiovascular system & hematology
Prosthesis Design
Compartment Syndromes
030218 nuclear medicine & medical imaging
Fasciotomy
Blood Vessel Prosthesis Implantation
Peripheral Arterial Disease
03 medical and health sciences
0302 clinical medicine
Fibrinolytic Agents
Blood vessel prosthesis
medicine.artery
Intravascular ultrasound
medicine
Humans
Popliteal Artery
Thrombolytic Therapy
Thrombus
Ultrasonography
Interventional
medicine.diagnostic_test
business.industry
Endovascular Procedures
Graft Occlusion
Vascular
Angiography
Digital Subtraction
Stent
Thrombosis
General Medicine
Middle Aged
medicine.disease
Popliteal artery
Blood Vessel Prosthesis
Surgery
Femoral Artery
Treatment Outcome
Female
Stents
Radiology
Cardiology and Cardiovascular Medicine
business
Fibrinolytic agent
Zdroj: Cardiovascular Revascularization Medicine. 17:134-137
ISSN: 1553-8389
DOI: 10.1016/j.carrev.2016.01.011
Popis: 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.
Databáze: OpenAIRE
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