[MO-66] Presentation Awards
Clinical outcomes of stent placement for vascular injuries
Purpose: Vascular injuries are caused by trauma or iatrogenic factors such as endovascular treatment or surgical operation. With the approval of VIABAHN® stent graft in Japan, stent placement become a new option for endovascular treatment of peripheral vascular injury. Stent placement is useful for bleeding from vessels as well as occlusive / dissecting lesions due to vascular crush, enabling both hemostasis and revascularization. In this study, an efficacy of stent placement for vascular injuries was evaluated.
Methods: Patients of vascular injuries were retrieved from a database who had been treated with stent placement from 2005 to 2018 in our department. Technical success of stent placement, recurrence of bleeding/occlusion, and perioperative mortality were retrospectively evaluated.
Results: There was 18 cases of vascular injury indicated for stent placement. The causes of injuries included 6 traumas, 11 iatrogenesis (8 cases due to endovascular treatment, 2 cases due to laparotomy, 1 case due to vascular anastomosis). Bare metal stents (BMS) were used in 7 cases of obstructive / dissecting lesions, and stent graft (SG) in 11 cases of vessel bleeding. SG included 7 cases of VIABAHN®, 2 cases of Advanta V12®, 1 case of NT-stent, 1 case of Fluenency®, and 1 case of Excluder® leg. At 2 cases, SG were placed in the portal vein. Stent placement was successfully performed at 94.4% (17/18). There was one delivery failure of VIABAHN® to proper hepatic artery because of vessel tortuosity, which was finally dealt with vessel embolziation. After stent placement, there was no recurrence of bleeding or occlusion. One patient died of multiple trauma despite the successful hemostasis of the lesion.
Conclusion: Stent placement was effective for traumatic/iatrogenic bleeding or occlusion of vessels. Vessel tortuosity can preclude delivery of stents to target points and careful anatomical evaluation is required prior to interventions.
Methods: Patients of vascular injuries were retrieved from a database who had been treated with stent placement from 2005 to 2018 in our department. Technical success of stent placement, recurrence of bleeding/occlusion, and perioperative mortality were retrospectively evaluated.
Results: There was 18 cases of vascular injury indicated for stent placement. The causes of injuries included 6 traumas, 11 iatrogenesis (8 cases due to endovascular treatment, 2 cases due to laparotomy, 1 case due to vascular anastomosis). Bare metal stents (BMS) were used in 7 cases of obstructive / dissecting lesions, and stent graft (SG) in 11 cases of vessel bleeding. SG included 7 cases of VIABAHN®, 2 cases of Advanta V12®, 1 case of NT-stent, 1 case of Fluenency®, and 1 case of Excluder® leg. At 2 cases, SG were placed in the portal vein. Stent placement was successfully performed at 94.4% (17/18). There was one delivery failure of VIABAHN® to proper hepatic artery because of vessel tortuosity, which was finally dealt with vessel embolziation. After stent placement, there was no recurrence of bleeding or occlusion. One patient died of multiple trauma despite the successful hemostasis of the lesion.
Conclusion: Stent placement was effective for traumatic/iatrogenic bleeding or occlusion of vessels. Vessel tortuosity can preclude delivery of stents to target points and careful anatomical evaluation is required prior to interventions.