Management of Inadvertent Proximal Vertebral Artery Cannulation by a Combined Endovascular/Surgical Approach

Ormiston, William; Merrilees, Stephen; Hill, Andrew; Brew, Stefan; McGuinness, Ben; Holden, Andrew

doi:10.1007/s00270-020-02619-x

Cited by 2 publications

(4 citation statements)

References 5 publications

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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 [1][2][3]. Endovascular treatment (EVT) with a stent graft (SG) is ideal for ULEAB because it simultaneously allows for hemostasis and maintains the blood ow of peripheral limb arteries [3][4][5][6][7]. A Viabahn SG is a heparin-coated self-expandable SG for lower extremity arterial disease that exhibits high exibility and accuracy in the delivery system.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, EVT with Viabahn SGs may be one of the best treatment options for ULEABs. Nevertheless, to date, reports regarding the outcomes of EVT with Viabahn SGs for ULEAB are limited [7][8][9][10][11]. This study aimed to evaluate emergency EVT using a Viabahn SG for ULEAB at various locations of arteries, focusing on technical aspects, e cacy, and safety.…”

Section: Introductionmentioning

confidence: 99%

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

Ueda¹,

Murata²,

Tajima³

et al. 2021

Preprint

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BackgroundA 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).MethodsConsecutive 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, re-bleeding, endoleaks, and patency of the SGs at 1, 3, 6, and 12 months were evaluated.ResultsEVT using Viabahn SG was performed in 22 patients (mean age: 72.0 years; 11 males) 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 and 8.9 mm, respectively. The mean neck length was 20.4 mm. No endoleaks or re-bleeding occurred during the follow-up period (mean: 169 days). Two SG occlusions without limb ischemia occurred in the external iliac artery and brachial artery 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.ConclusionsEmergency 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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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Ueda¹,

Murata²,

Tajima³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…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%

“…Therefore, EVT with Viabahn SGs may be one of the best treatment options for ULEABs. Nevertheless, to date, reports regarding the outcomes of EVT with Viabahn SGs for ULEAB are limited (Ormiston et al 2020 ; DuBose et al 2012 ; Kufner et al 2015 ; Backer et al 2015 ; Desai et al 2014 ). This study aimed to evaluate emergency EVT using a Viabahn SG for ULEAB at various locations of arteries, focusing on technical aspects, short-term efficacy, and safety.…”

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

View full text Add to dashboard Cite

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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Management of Inadvertent Proximal Vertebral Artery Cannulation by a Combined Endovascular/Surgical Approach

Cited by 2 publications

References 5 publications

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

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

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

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