JET2019

Presentation information

Presentation Awards

[L2-8] Presentation Awards

Heat-12 Aortoiliac-1

Sat. Feb 23, 2019 1:20 PM - 2:50 PM HallL-2 (Nexus)

Moderator: Shin Takiuchi(Higashi Takarazuka Satoh Hospital),Po-Jen Ko(Chang Gung Memorial Hospital)
Panelist: Chih-Hsiang Hsu(China Medical University Hospital, Taiwan),Keiichi Hishikari(横須賀共済病院)

[MO-73] Presentation Awards

The Challenging cases for complex Aortoiliac occlusive disease (AIOD) with iliac covered stent ~ the case series of VIABAHN VBX stent~

Tomofumi Tsukizawa

Introduction

Endovascular therapy for peripheral artery disease has been widely applied. Especially in iliac artery disease is the maintarget of revascularization supported by evidence and guidelines. Otherwise, complex lesions such as Leriche syndrome, repeat occlusion, andseverelycalcified lesionare still a challengingsituation. The Iliac covered balloon expandable stent VIAVAHN VBX (W.L. Gore & Associates, Flagstaff, AZ, USA) is the latest and high expectation device for complex aortoiliac disease by endovascular work. This presentation aims to report 3 cases of VIABAHN VBX stent implanted in the AIOD.

Case-1

A 76-year-old gentleman was admittedfor treatment of intermittent both side claudication. Diagnostic angiography showed chronic total occlusion from theinfra-renalterminal aorta to bilateral common iliac arteries. We tried to intervene by endovascular approach. After the guidewire crossing, the four VIIABAHN VBX stent and two self-expanding bare nitinol stent were implantedwith kissing stent technique (Figure). No complication occurredand the patient’s symptoms immediately resolved.

Case-2

A 48-year-old gentlemanwas admittedwith both side intermittentclaudication recurrent. He was treatedby bare nitinol stent kissing implantation for 12 months ago. Otherwise, duplex ultrasound shows re-occlusion of left side stent. Firstly, we treated angioplasty for ISR lesion. Otherwise, re-re occluded within 24 hours. The two VIIABAHN VBX stent were kissing in-stent-implanted. After the procedure, thesymptom is free,andthe keep the vessel patency.

Case-3

A 78-year-old lady was admittedfor both side calf intermittent claudication. CT angioshowed severe calcified dense in the terminalaorta to common iliac artery. The two VIABAHN VBX stents were implantedby kissing stent technique. Her symptom was improved immediately.

Conclusion

The latest iliac covered stent is safety and efficacy also complex aortoiliac disease. This technological innovation might be changing the primarystrategy for complex AIOD.