Placement of Balloon-expandable Intraluminal Stents in Iliac Arteries: First 171 Procedures

Palmaz, Julio C.; Garcia, O.; Schatz, Richard; Rees, Chet R.; Roeren, T; Richter, Goetz M.; Noeldge, Gerd; Gardiner, Geoffrey A.; Becker, Gary J.; Walker, Craig M.; Stagg, Jody; Katzen, Barry T.; Dake, Michael D.; Paolini, R. M.; McLean, Gordon K.; Lämmer, Johannes; Schwarten, Donald E.; Tio, Fermin O.; Root, Harlan D; Rogers, William E.

doi:10.1148/radiology.174.3.174-3-969

Cited by 187 publications

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“…The use of expandable metallic prostheses (stents) was reported for coronary, peripheral, and native renal vascular stenosis [15]. Its use in transplant RAS is limited and most papers include only adult patients [16,17,18,19,20,21].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous treatment of transplant renal artery stenosis in children

Repetto¹,

Rodríguez-Rilo²,

Mendaro³

et al. 2004

Pediatr Nephrol

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Percutaneous treatment of renal artery stenosis (RAS) is an accepted procedure and numerous reports have been published. However, experience with its use in RAS in the transplanted kidney in children is scarce. Since 1994 we have diagnosed RAS in seven children with the use of Doppler ultrasonography (US), confirming it with percutaneous angiography (PAG). In six of the seven patients percutaneous transluminal angioplasty (PTA) was performed. In one patient a metallic stent was placed due to the extension of the arterial lesion, and a second stent was placed in another child when a re-stenosis was diagnosed 1 month after the PTA. All patients presented with hypertension (de novo or 30% increase over previous values). After ruling out acute rejection, calcineurin inhibitor toxicity, and urinary obstruction, US was performed and, when an increase in arterial flux velocity was registered, PAG was also performed. Six children showed an increase in serum creatinine (Cr) and proteinuria. Blood pressure decreased after the procedure and Cr returned to previous levels in all children. One of the grafts was lost due to chronic transplant rejection 7 years later. The other children have a functioning kidney. Although this is a small group of patients, the consistently good results and the lack of reported experience prompted us to communicate our preliminary observation.

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Section: Introductionmentioning

confidence: 99%

Percutaneous treatment of transplant renal artery stenosis in children

Repetto¹,

Rodríguez-Rilo²,

Mendaro³

et al. 2004

Pediatr Nephrol

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“…In order to overcome some of these limitations in balloon angioplasty therapy, intravascular stents were used to treat peripheral and coronary arterial stenoses initially [9,10]. Shortly thereafter, balloon-expandable stents were successfully implanted to treat native or postoperative stenoses of the pulmonary artery branches, systemic vena cavae, and conduits associated with congenital heart disease [11].…”

Section: Introductionmentioning

confidence: 99%

Stenting of coarctation of the aorta

Cheatham

2001

Cathet Cardio Intervent

147

132

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The purpose of the present study was to assess the usefulness of balloon expandable Palmaz intravascular stents in the transcatheter treatment of children and young adults with native and recurrent coarctation of the aorta, and to develop an improved intravascular stent and balloon delivery catheter specifically developed for vascular obstructions associated with congenital heart disease, including coarctation of the aorta. Twenty-one patients, 8 native and 13 recurrent coarctations, were successfully treated with the Palmaz stent. However, limitations and disadvantages in stent design and the single balloon delivery system were uncovered. Therefore, the NuMED CP stent and BIB delivery catheter were developed and used to treat 25 patients with native (17) and recurrent (8) coarctation successfully. Improvements in stent design and long-term follow-up using three-dimensional spiral CT scan will be helpful in determining the role of transcatheter stent therapy for native and recurrent coarctation of the aorta. Cathet Cardiovasc Intervent 2001;54:112-125.

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“…Because of the success of percutaneous stenting of atherosclerotic lesions in other arterial systems, [7][8][9][10] several centers have investigated the less invasive alternative of stenting severe carotid stenoses. [11][12][13][14][15][16] However, fear of distal embolization of plaque fragments to the brain has generated concern regarding the safety and wisdom of this approach, especially considering the established low risk and durability of endarterectomy.…”

mentioning

confidence: 99%

Carotid Artery Stenting Protected With an Emboli Containment System

Whitlow

Lylyk

Londero

et al. 2002

Stroke

152

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Background and Purpose-Fear of distal embolization and stroke has aroused concern regarding carotid stenting. Devices to protect the cerebral circulation may make carotid stenting safer. Methods-A multidisciplinary study group tested a balloon occlusion-aspiration emboli entrapment device in conjunction with carotid stenting. The device consists of an elastomeric balloon on a steerable wire with a detachable adapter that inflates and deflates the distal temporary occlusion balloon. An aspiration catheter is used to remove trapped emboli after stenting and before occlusion balloon deflation. Results-Seventy-five patients with severe internal carotid artery stenosis were treated with stents deployed with this cerebrovasculature protection system. All 75 patients (100%) had grossly visible particulate material aspirated, and all were treated successfully without major or minor stroke or death at 30 days. Preintervention stenosis was 81Ϯ10%, and residual stenosis was 5Ϯ7%. Nine patients (12%) had angiographic evidence of thrombus before intervention, but no patient had thrombus or vessel cutoff after the procedure. Four patients (5%) developed transient neurological symptoms during protection balloon occlusion, but symptoms resolved with balloon deflation. The 22 to 667 particles aspirated per patient ranged from 3.6 to 5262 m in maximum diameter (mean, 203Ϯ256 m). These particles included fibrous plaque debris, lipid or cholesterol vacuoles, and calcific plaque fragments. Conclusions-Protected carotid stenting was performed successfully and safely in this study early in the experience with cerebrovascular protection devices. Particulate emboli are frequent with stenting, and cerebral protection will likely be necessary to minimize stroke. Randomized trials comparing protected carotid stenting with endarterectomy are warranted.

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Placement of Balloon-expandable Intraluminal Stents in Iliac Arteries: First 171 Procedures

Cited by 187 publications

References 0 publications

Percutaneous treatment of transplant renal artery stenosis in children

Percutaneous treatment of transplant renal artery stenosis in children

Stenting of coarctation of the aorta

Carotid Artery Stenting Protected With an Emboli Containment System

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