[MO-15] A case of iatrogenic dissection of external iliac artery treated with VIABAHN stent graft
A 61 - year – old female presenred with intermittent claudication of the right lower limb. She underwent Catheter Ablation for Paroxysmal Atrial Fibrillation a month ago, and she began to become aware of the symptoms shortly afterwards. Lower limb contrast CT showed diffuse stenosis throughout the external iliac artery and a contrast agent pool on the blood vessel wall at the distal part. Angiography and intravascular ultrasound showed dissection entry in the distal part of the ilium where the contrast agent 's pool was confirmed. It was local, but hematoma continued until the bifurcation of the internal and external iliacs and was compressing the true lumen. We thought that dissection was caused by wire operation during Catheter Ablation and thrombosis was occurred in the subsequent course. Although the entry of dissection is not aneurysm but it is enlarged, we thought that Sealing of dissection entrance part is necessary. We also wanted to release the diffuse stenosis of the entire external iliac artery to improve the symptoms. We elected to place an 8 mm x 100 mm VIABAHN stent graft at the extrernal iliac artery, and balloon angioplasty was performed to expand the deployed stent graft. Despite successful expansion, unfortunately, the thrombus of hematoma protruded from the proximal edge of the stent graft and additional use of an 8 mm x 25 mm VIABAHN stent graft was perfomed. Her intermittent claudication was improved. We would like to verify whether Balloon expansion was necessary, if we needed it, what kind of ingenuity would be required, and whether the use of the stent graft was reasonable.