Emergency endovascular treatment using a Viabahn stent graft for upper and lower extremity arterial bleeding: a retrospective study

CVIR Endovascular

Satoru Murata¹  Hiroyuki Tajima²  Takahiko Mine³  Shohei Mizushima³  Fumie Sugihara⁴  Shin-Ichiro Kumita⁴  Hiromitsu Hayashi⁴  Tatsuo Ueda⁴  Hidemasa Saito⁴  Daisuke Yasui⁵  Hiroshi Kawamata⁶ 

[1] Center for Interventional Radiology, Teikyo University Chiba Medical Center, 3426-3 Anesaki, 299-0011, Ichihara City, Chiba, Japan;Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, 350-1298, Hidaka City, Saitama, Japan;Department of Radiology, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, 270-1694, Inzai City, Chiba, Japan;Department of Radiology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan;Department of Radiology, Nippon Medical School Musashi Kosugi Hospital, 1-396 Kosugi-machi, Nakahara-ku, 211-8533, Kawasaki City, Kanagawa, Japan;Department of Radiology, Yokohama Rosai Hospital, 3211 Kozukue-Cho, Kohoku-Ku, 222-0036, Yokohama City, Kanagawa, Japan;

关键词: Viabahn;    Stent graft;    Upper extremity;    Lower extremity;    Arterial bleeding;   

DOI  :  10.1186/s42155-021-00273-z

来源: Springer

【 摘 要 】

BackgroundA Viabahn stent graft (SG) is a heparin-coated self-expandable SG for lower extremity arterial disease that exhibits high flexibility and accuracy in the delivery system. This study aimed to evaluate the short-term efficacy and safety of emergency endovascular treatment (EVT) using a Viabahn SG for upper and lower extremity arterial bleeding (ULEAB).MethodsConsecutive patients with ULEAB who underwent emergency EVT using the Viabahn SG between January 2017 and August 2021 were retrospectively reviewed. The indications for EVT, location of artery, technical success, clinical success, limb ischemia, periprocedural complications, bleeding-related mortality, 30-day mortality, diameter of the target artery, diameter of the SG, neck length, rebleeding, endoleaks, and patency of the SGs at 1, 3, 6, and 12 months were evaluated.ResultsEVT using the Viabahn SG was performed in 22 patients (mean age, 72.0 ± 13.0 years; 11 men) and 23 arteries (upper, 6; lower, 17). The indications for EVT were pseudoaneurysm (n = 13, 59.1%), extravasation (n = 9, 39.1%), and inadvertent arterial cannulation (n = 1, 4.3%). The anatomical locations of the 23 ULEAB injuries were the brachiocephalic (1 [4.3%]), subclavian (3 [13.0%]), axillary (1 [4.3%]), brachial (1 [4.3%]), common iliac (4 [17.4%]), external iliac (8 [34.8%]), common femoral (2 [8.7%]), superficial femoral (2 [8.7%]), and popliteal (1 [4.3%]) arteries. The technical and clinical success rates were 100%. The rates of limb ischemia, periprocedural complications, and bleeding-related mortality were 0%, whereas the 30-day mortality rate was 22.7%. The mean diameters of the arteries and SGs were 7.7 ± 2.2 and 8.9 ± 2.3 mm, respectively. The mean neck length was 20.4 ± 11.3 mm. No endoleaks or rebleeding occurred during the follow-up period (mean, 169 ± 177 days). Two SG occlusions without limb ischemia occurred in the external iliac and brachial arteries after 1 and 4 months, respectively. Subsequently, cumulative SG patency was confirmed after 1, 3, 6, and 12 months in 91.7%, 91.7%, 81.5%, and 81.5% of patients, respectively.ConclusionsEmergency EVT using the Viabahn SG for ULEAB was effective and safe according to short-term outcomes. Appropriate size selection and neck length are important for successful treatment. SG patency was good after 1, 3, 6, and 12 months.

【 授权许可】

CC BY