Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing Stenting
Endovascular therapy for iliac artery chronic total occlusions is nowadays associated with low rates of procedure-related complications and improved clinical outcomes, and it is predominantly used as first-line therapy prior to aortobifemoral bypass grafting. Herein, we describe the case of a patien...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Vascular Medicine |
| Online Access: | http://dx.doi.org/10.1155/2015/451962 |
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| author | George S. Georgiadis Efstratios I. Georgakarakos Nikolaos Schoretsanitis Christos C. Argyriou George A. Antoniou Miltos K. Lazarides |
| author_facet | George S. Georgiadis Efstratios I. Georgakarakos Nikolaos Schoretsanitis Christos C. Argyriou George A. Antoniou Miltos K. Lazarides |
| author_sort | George S. Georgiadis |
| collection | DOAJ |
| description | Endovascular therapy for iliac artery chronic total occlusions is nowadays associated with low rates of procedure-related complications and improved clinical outcomes, and it is predominantly used as first-line therapy prior to aortobifemoral bypass grafting. Herein, we describe the case of a patient presenting with an ischemic left foot digit ulcer and suffering complex aortoiliac lesions, who received common iliac arteries kissing stents, illustrating at final antegrade and retrograde angiograms the early recognition of a blood flow obstructing valve-like calcified intimal flap protruding through the stent struts, which was obstructing antegrade but not retrograde unilateral iliac arterial axis blood flow. The problem was resolved by reconstructing the aortic bifurcation at a more proximal level. Completion angiogram verified normal patency of aorta and iliac vessels. Additionally, a severe left femoral bifurcation stenosis was also corrected by endarterectomy-arterioplasty with a bovine patch. Postintervention ankle brachial pressure indices were significantly improved. At the 6-month and 2-year follow-up, normal peripheral pulses were still reported without intermittent claudication suggesting the durability of the procedure. Through stent-protruding calcified intimal flap, is a very rare, but existing source of antegrade blood flow obstruction after common iliac arteries kissing stents. |
| format | Article |
| id | doaj-art-03dd25f8e98342419c5905d9824d3e09 |
| institution | Kabale University |
| issn | 2090-6986 2090-6994 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Vascular Medicine |
| spelling | doaj-art-03dd25f8e98342419c5905d9824d3e092025-02-03T01:12:24ZengWileyCase Reports in Vascular Medicine2090-69862090-69942015-01-01201510.1155/2015/451962451962Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing StentingGeorge S. Georgiadis0Efstratios I. Georgakarakos1Nikolaos Schoretsanitis2Christos C. Argyriou3George A. Antoniou4Miltos K. Lazarides5Department of Vascular Surgery, “Democritus” University of Thrace, University General Hospital of Alexandroupolis, GreeceDepartment of Vascular Surgery, “Democritus” University of Thrace, University General Hospital of Alexandroupolis, GreeceDepartment of Vascular Surgery, “Democritus” University of Thrace, University General Hospital of Alexandroupolis, GreeceDepartment of Vascular Surgery, “Democritus” University of Thrace, University General Hospital of Alexandroupolis, GreeceLiverpool Vascular and Endovascular Service, Royal Liverpool University Hospital, Liverpool, UKDepartment of Vascular Surgery, “Democritus” University of Thrace, University General Hospital of Alexandroupolis, GreeceEndovascular therapy for iliac artery chronic total occlusions is nowadays associated with low rates of procedure-related complications and improved clinical outcomes, and it is predominantly used as first-line therapy prior to aortobifemoral bypass grafting. Herein, we describe the case of a patient presenting with an ischemic left foot digit ulcer and suffering complex aortoiliac lesions, who received common iliac arteries kissing stents, illustrating at final antegrade and retrograde angiograms the early recognition of a blood flow obstructing valve-like calcified intimal flap protruding through the stent struts, which was obstructing antegrade but not retrograde unilateral iliac arterial axis blood flow. The problem was resolved by reconstructing the aortic bifurcation at a more proximal level. Completion angiogram verified normal patency of aorta and iliac vessels. Additionally, a severe left femoral bifurcation stenosis was also corrected by endarterectomy-arterioplasty with a bovine patch. Postintervention ankle brachial pressure indices were significantly improved. At the 6-month and 2-year follow-up, normal peripheral pulses were still reported without intermittent claudication suggesting the durability of the procedure. Through stent-protruding calcified intimal flap, is a very rare, but existing source of antegrade blood flow obstruction after common iliac arteries kissing stents.http://dx.doi.org/10.1155/2015/451962 |
| spellingShingle | George S. Georgiadis Efstratios I. Georgakarakos Nikolaos Schoretsanitis Christos C. Argyriou George A. Antoniou Miltos K. Lazarides Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing Stenting Case Reports in Vascular Medicine |
| title | Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing Stenting |
| title_full | Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing Stenting |
| title_fullStr | Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing Stenting |
| title_full_unstemmed | Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing Stenting |
| title_short | Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing Stenting |
| title_sort | valve like and protruding calcified intimal flap complicating common iliac arteries kissing stenting |
| url | http://dx.doi.org/10.1155/2015/451962 |
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