Chopstick Injury: Successful Stent-Graft Therapy for Traumatic Left Subclavian Artery Aneurysm

Ueda, Tatsuo; Tajima, Hiroyuki; Murata, Satoru; Takagi, Ryo; Kumita, Shin‐ichiro

doi:10.1272/jnms.84.41

Cited by 5 publications

(3 citation statements)

References 7 publications

(5 reference statements)

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“…Until recently, open surgical revascularization was the only treatment for acute EIA injury following blunt trauma 4 . Less invasive treatment options, such as endovascular stent-graft implantation, have been recently adopted for the treatment of other injuries 7 . Although a few studies have reported the effectiveness of stent-graft implantation in the acute phase of EIA injurys 5,6 , to the best of our knowledge, none have reported its feasibility in the subacute phase.…”

Section: Discussionmentioning

confidence: 99%

Elective Endovascular Stent-Graft Implantation for External Iliac Artery Injury after Blunt Pelvic Trauma

et al. 2022

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External iliac artery (EIA) injuries caused by blunt trauma are rare. Here, we present the case of a 16-year-old boy who suffered a blunt EIA injury following a motorbike accident.Despite conservative treatment, the intermittent claudication persisted. He was successfully treated using elective endovascular stent-graft implantation on day 59 after the injury. The patient's ankle-brachial index (ABI) improved along with his symptoms.A contrast-enhanced computed tomography scan on postoperative day 90 showed no residual stenosis and favorable peripheral blood flow. This report suggests that elective endovascular stent-graft implantation might be a viable option for the treatment of blunt EIA injuries.

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Section: Discussionmentioning

confidence: 99%

Elective Endovascular Stent-Graft Implantation for External Iliac Artery Injury after Blunt Pelvic Trauma

et al. 2022

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“…Therefore, indications for trans-arterial embolization must be assessed carefully to avoid ischemic complications. EVT with stentgrafts (SGs) is an ideal treatment for AIBs because it simultaneously permits hemostasis and maintains the blood flow to peripheral organs [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Endovascular treatment with Viabahn stent-grafts for arterial injury and bleeding at the visceral arteries: initial and midterm results

et al. 2021

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Purpose The purpose of the study is to evaluate the initial and midterm efficacy and safety of endovascular treatment (EVT) using Viabahn stent-graft (SG) for arterial injury and bleeding (AIB) at the visceral arteries. Materials and methods Consecutive patients with visceral AIB who underwent EVT using Viabahn between January 2017 and February 2021 were retrospectively reviewed. Technical success, clinical success, peripheral organ ischemia, peri-procedural complications, bleeding-related mortality, 30-day mortality, neck length, re-bleeding, endoleaks, and patency of the SGs at 1, 3, 6, and 12 months were evaluated. Results EVT using Viabahn was performed in 14 patients (mean age: 68.6 years; 12 males) and 15 arteries. The technical and clinical success rates were 100%. The rates of peripheral organ ischemia, peri-procedural complications, bleeding-related mortality, and 30-day mortality were all 0%. The mean neck length was 9.9 mm. No endoleaks or re-bleeding occurred during the follow-up (mean: 732 days). The SG patency was confirmed after 1, 3, 6, and 12 months in 78.6%, 78.6%, 78.6%, and 56.1% of the patients, respectively. Conclusion EVT using Viabahn for AIB at the visceral arteries was safe and effective. SG occlusions without ischemia often occurred after 12 months.

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“…Conventionally, upper and lower extremity arterial bleeding (ULEAB) has been treated surgically; however, currently, a less invasive endovascular approach is favored (Waes et al 2013 ; Fox et al 2012 ; Katsanos et al 2009 ). Endovascular treatment (EVT) with a stent graft (SG) is ideal for ULEAB because it simultaneously allows for hemostasis and maintains the blood flow of peripheral limb arteries (Katsanos et al 2009 ; Ueda et al 2017 , 2021 ; Venturini et al 2017 ; Ormiston et al 2020 ). A Viabahn SG (W. L. Gore & Associates, Flagstaff, AZ, USA) is a heparin-coated self-expandable SG for lower extremity arterial disease that exhibits high flexibility and accuracy in the delivery system.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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Background A 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). Methods Consecutive 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. Results EVT 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. Conclusions Emergency 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.

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Chopstick Injury: Successful Stent-Graft Therapy for Traumatic Left Subclavian Artery Aneurysm

Cited by 5 publications

References 7 publications

Elective Endovascular Stent-Graft Implantation for External Iliac Artery Injury after Blunt Pelvic Trauma

Elective Endovascular Stent-Graft Implantation for External Iliac Artery Injury after Blunt Pelvic Trauma

Endovascular treatment with Viabahn stent-grafts for arterial injury and bleeding at the visceral arteries: initial and midterm results

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

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