Reconstruction of stenotic or occluded iliofemoral veins and inferior vena cava using intravascular stents: re-establishing access for future cardiac catheterization and cardiac surgery
| Autor: | James C. Perry, SK Clapp, Ronald G. Grifka, James W. Mathewson, Thomas E. Fagan, Mark W. Cocalis, Michael R. Nihill, Frank F. Ing, Charles E. Mullins |
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| Rok vydání: | 2001 |
| Předmět: |
Heart Defects
Congenital Male medicine.medical_specialty Cardiac Catheterization medicine.medical_treatment Vena Cava Inferior Constriction Pathologic Iliac Vein Inferior vena cava Medicine Stent implantation Humans Cardiac catheterization business.industry Vascular disease Mean Vessel Diameter Stent Femoral Vein medicine.disease Surgery Venous access Cardiac surgery Treatment Outcome medicine.vein Child Preschool cardiovascular system Female Stents Radiology business Cardiology and Cardiovascular Medicine Angioplasty Balloon |
| Zdroj: | Journal of the American College of Cardiology. 37(1):251-257 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/s0735-1097(00)01091-3 |
| Popis: | OBJECTIVESThe study evaluated the safety and efficacy of stent reconstruction of stenotic/occluded iliofemoral veins (IFV) and inferior vena cava (IVC).BACKGROUNDPatients with congenital heart defects and stenotic or occluded IFV/IVC may encounter femoral venous access problems during future cardiac surgeries or catheterizations.METHODSTwenty-four patients (median age 4.9 years) underwent implantation of 85 stents in 22 IFV and 6 IVC. Fifteen vessels were severely stenotic and 13 were completely occluded. Although guide wires were easily passed across the stenotic vessels, occluded vessels required puncture through the thrombosed sites using a stiff wire or transseptal needle. Once traversed, the occluded site was dilated serially prior to stent implantation.RESULTSFollowing stent placement, the mean vessel diameter increased from 0.9 ± 1.6 to 7.4 ± 2.6 mm (p < 0.05). Twenty-one of 28 vessels had long segment stenosis/occlusion requiring two to seven overlapping stents. Repeat catheterizations were performed in seven patients (9 stented vessels) at mean follow-up of 1.6 years. Seven vessels remained patent with mean diameter of 6.4 ± 2.0 mm. Two vessels were occluded, but they were easily recanalized and redilated. Echocardiographic follow-up in two patients with IVC stents demonstrated wide patency. In four additional patients, a stented vessel was utilized for vascular access during subsequent cardiac surgery (n = 3) and endomyocardial biopsy (n = 1). Therefore, 13 of 15 stented vessels (87%) remained patent at follow-up thus far.CONCLUSIONSStenotic/obstructed IFV and IVC may be reconstructed using stents to re-establish venous access to the heart for future cardiac catheterization and/or surgeries. |
| Databáze: | OpenAIRE |
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