Endovascular Treatment of Venous Bypass Graft Pseudoaneurysm with the New Solaris Self-Expanding Covered Stent

Abstract

Nonanastomotic pseudoaneurysm formation after vascular reconstruction is a rarely encountered problem. Covered stent graft constitutes a minimal approach. To our knowledge, the present study constitutes the first case of implantation of Solaris stent graft in Europe. A 69-year-old man with severe cardiac dysfunction presented a pseudoaneurysm of a popliteal to popliteal artery reversed saphenous vein bypass graft. The patient was successfully treated by the percutaneous placement of a Solaris self-expanding covered stent. The postimplantation arteriogram demonstrated exclusion of the pseudoaneurysm, complete apposition of the stent, and adequate runoff. No complications occurred, and the patient was discharged from the hospital one day later receiving 75 mg of clopidogrel. Endovascular exclusion by covered stent deployment offers a safe, rapid, and minimally invasive alternative to open surgical resection in patients with lower limb venous graft pseudoaneurysm. The Solaris covered stent provides a new catheter-based device with adequate navigability and exceptional accurate delivery system.

The Technological Advancement to Engineer Next‐Generation Stent‐Grafts: Design, Material, and Fabrication Techniques

“…In conjunction with radial compliance, known as an essential design property for a vascular implant, successful mimicking of natural artery behavior relies on the incorporation of other elements such as nonlinearity and anisotropy. [50] The use of polymer-based fabrics or laminates in endovascular grafts evolved from their applications in open surgical repair, where either woven fabrics using fabrication technologies like weaving, [51] knitting, [52,53] braiding, [54,55] or nontextile fabrics through extrusion forming [56] and electrospinning [57,58] have been employed. Based on the fabrication technology, the material and design of the graft can differ.…”

“…Covered stents can be effective in the treatment of conditions like fistulae, congenital vascular disease, neurovascular disease, and coarctation of the aorta. [58,95,96] To prevent restenosis in smaller arteries, covered stents can act as an effective drug delivery platform for the localized release of therapeutic agents.…”

“…More recently, synthetic nanocomposite polymers were employed. Electrospinning (e.g., Solaris SG by Scitech Medical [58] ), casting and Langmuir-Blodgett techniques, layer-by-layer assembly, and polymer sleeve braiding are some of the techniques used to make low profile covering membranes. [95] In a ten-year clinical study of commercially covered stents (i.e., Wallgraft; Boston Scientific, Jostent; Jomed, iCast; Atrium Medical, Fluency; Bard, and Jostent Graft Master; Abbott Vascular) to treat superior mesenteric artery pseudoaneurysms, technical and clinical success with mid-term stent patency was reported.…”

Endovascular Double-Layer Bare Stent Placement in the Treatment of Posttraumatic Pseudoaneurysm

“…The lesion is known as a pseudoaneurysm because there is no normal three-layer structure of arteries [1]. Pseudoaneurysm can, if left untreated, become a life-threatening situation by thrombosis, rupture, or distal embolization [2]. Thus, proper and timely treatment is very important.…”

Images in Vascular Medicine: Heart-shaped saphenous vein graft pseudoaneurysm - Endovascular repair with covered stent

“…2 In contrast, very few studies have demonstrated the utility of endovascular therapy for vein bypass graft pseudoaneurysm. 3 The clinical usefulness of stents in infrainguinal vein grafts is not yet established, and their safety and efficacy remain unclear. However, the case we have described, as evidenced in Panel C, demonstrates the utility of such a stent in the infrainguinal region, even for pseudoaneurysms with unusual shapes.…”