BACKGROUND Aortoiliac artery stenting has been accepted as the preferred option for the treatment of aortoiliac artery disease because of lower morbidity and mortality compared with bypass surgery.However,acute stent ...BACKGROUND Aortoiliac artery stenting has been accepted as the preferred option for the treatment of aortoiliac artery disease because of lower morbidity and mortality compared with bypass surgery.However,acute stent occlusion is a troublesome complication due to the need for open surgery or the risk of distal embolization.Herein,we reported a novel approach to treat the acute thrombotic occlusion of an aortoiliac stent using both hemolytic and conventional mechanical thrombectomy coupled with a large diameter sheath.CASE SUMMARY A 64-year-old male patient presented with severe claudication of the right leg.The patient's history included multiple prior interventions for aortoiliac lesions.The preoperative computed tomography(CT)imaging showed a thrombotic occlusion of right aortoiliac stenting.An Angiojet Omni thrombectomy catheter(Boston Scientific,Marlborough,MA,United States)was used to remove the thrombus in a retrograde fashion after the successful placement of the large-diameter sheath in the right common femoral artery for prevention of distal embolization.The remnant organized thrombus was removed with an over-the-wire Fogarty catheter(Edwards Lifesciences,Irvine,CA,United States).Completion angiogram and postoperative CT imaging demonstrated complete removal of thrombus and no evidence of distal embolization.CONCLUSION This novel approach provides successful management of acute thrombotic occlusion of aortoiliac stent without distal embolization.展开更多
BACKGROUND In endovascular procedures including total percutaneous endovascular aneurysm repair(pEVAR),percutaneous access through the common femoral artery is most commonly performed.Access-site bleeding is a major c...BACKGROUND In endovascular procedures including total percutaneous endovascular aneurysm repair(pEVAR),percutaneous access through the common femoral artery is most commonly performed.Access-site bleeding is a major concern in percutaneous techniques.Herein,we present a case of successful control of continuous oozing using a vascular closure device(VCD)and the application of Surgicel(Johnson&Johnson,United States)over the access tract.CASE SUMMARY An 82-year-old man presented with an unruptured abdominal aortic aneurysm measuring 83 mm×75 mm.The patient had a medical history of atrial fibrillation and was receiving rivaroxaban(15 mg/d).Routine pEVAR was performed using the preclose technique with ProGlide(Abbott,Santa Clara,CA,United States).Significant amount of bleeding was observed at the end of the procedure after the deployment of the closure device at the access site.A sheet of Surgicel was applied to the suture thread using a surgical needle.Surgicel was applied to the surface of the artery along the access tract using a pusher,and hemostasis was immediately attained.CONCLUSION This simple technique is an excellent adjunct to control residual bleeding from the access site following VCD use.展开更多
文摘BACKGROUND Aortoiliac artery stenting has been accepted as the preferred option for the treatment of aortoiliac artery disease because of lower morbidity and mortality compared with bypass surgery.However,acute stent occlusion is a troublesome complication due to the need for open surgery or the risk of distal embolization.Herein,we reported a novel approach to treat the acute thrombotic occlusion of an aortoiliac stent using both hemolytic and conventional mechanical thrombectomy coupled with a large diameter sheath.CASE SUMMARY A 64-year-old male patient presented with severe claudication of the right leg.The patient's history included multiple prior interventions for aortoiliac lesions.The preoperative computed tomography(CT)imaging showed a thrombotic occlusion of right aortoiliac stenting.An Angiojet Omni thrombectomy catheter(Boston Scientific,Marlborough,MA,United States)was used to remove the thrombus in a retrograde fashion after the successful placement of the large-diameter sheath in the right common femoral artery for prevention of distal embolization.The remnant organized thrombus was removed with an over-the-wire Fogarty catheter(Edwards Lifesciences,Irvine,CA,United States).Completion angiogram and postoperative CT imaging demonstrated complete removal of thrombus and no evidence of distal embolization.CONCLUSION This novel approach provides successful management of acute thrombotic occlusion of aortoiliac stent without distal embolization.
文摘BACKGROUND In endovascular procedures including total percutaneous endovascular aneurysm repair(pEVAR),percutaneous access through the common femoral artery is most commonly performed.Access-site bleeding is a major concern in percutaneous techniques.Herein,we present a case of successful control of continuous oozing using a vascular closure device(VCD)and the application of Surgicel(Johnson&Johnson,United States)over the access tract.CASE SUMMARY An 82-year-old man presented with an unruptured abdominal aortic aneurysm measuring 83 mm×75 mm.The patient had a medical history of atrial fibrillation and was receiving rivaroxaban(15 mg/d).Routine pEVAR was performed using the preclose technique with ProGlide(Abbott,Santa Clara,CA,United States).Significant amount of bleeding was observed at the end of the procedure after the deployment of the closure device at the access site.A sheet of Surgicel was applied to the suture thread using a surgical needle.Surgicel was applied to the surface of the artery along the access tract using a pusher,and hemostasis was immediately attained.CONCLUSION This simple technique is an excellent adjunct to control residual bleeding from the access site following VCD use.
