Simultaneous Kissing Stent Technique with Stent Grafts for Subclavian Artery Aneurysm: A Case Report

Li, Liqiang; Yu, Heng; Qi, Yongfen; Qi, Lixing; Li, Jianxin; Gu, Yongquan; Zhang, Jian

doi:10.1016/j.avsg.2015.02.018

Cited by 7 publications

(3 citation statements)

References 12 publications

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“…They typically require a combined mediastinal approach to control the innominate and right common carotid arteries and a supraclavicular or infraclavicular exposure for distal control, with a higher incidence of postoperative complications. [15][16][17][18] Recently, hybrid management combining a covered stent and an extra-anatomical bypass has been reported to exclude intrathoracic right ISAAs, avoiding a mediastinal incision and presenting a favorable outcome. [19][20][21][22] Despite this, the invasion and postoperative complications are still non-negligible, especially for high-risk aged patients.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of endovascular treatment of isolated subclavian artery aneurysms

Fang

et al. 2020

Vascular

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Objectives The aim of the present study was to review our institutional experience of endovascular treatment for isolated subclavian artery aneurysms and evaluate the long-term outcomes. Methods A retrospective review of all patients with isolated subclavian artery aneurysms who underwent endovascular treatment between March 2008 and March 2020 was performed. The demographics, aneurysmal characteristics, treatment strategies, and in-hospital and follow-up outcomes were recorded and then analyzed. Results From March 2008 to March 2020, 35 isolated subclavian artery aneurysms were endovascularly treated at our institution. Atherosclerosis was the most common cause of aneurysms in this series. Most aneurysms were intrathoracic (91.4%) and located at the right side (77.1%). There were 26 true aneurysms, seven pseudoaneurysms, and two ruptured isolated subclavian artery aneurysms. Five types of endovascular strategies were performed. Covered stent placement across the aneurysm was the most (54.3%) commonly used method. Technical success was achieved in all patients. The median postoperative in-hospital stay was 4.0 days (range, 1–15 days). One patient died after discharge but within 30 days of surgery due to myocardial infarction. The median follow-up time was 62.0 months (range, 3–132 months). No death, stroke, stent fractures, or severe upper limb ischemia developed during the follow-up period. The cumulative survival rate at five years was 97.1%. The overall complication rate was 25.7% and one-third of complications (8.6%) required reinterventions. Conclusions Endovascular treatment for isolated subclavian artery aneurysms is safe, effective and technically achievable in most patients. Short- and long-term outcomes are promising. Reasonable and flexible use of covered stents can also get satisfactory outcomes in some complicated lesions such as isolated subclavian artery aneurysms located at the origin of the right subclavian artery, avoiding the huge surgical trauma caused by conventional open repair.

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Section: Discussionmentioning

confidence: 99%

Long-term outcomes of endovascular treatment of isolated subclavian artery aneurysms

Fang

et al. 2020

Vascular

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“…When the neck of the aneurysm is very close to the proximal end of subclavian artery (right), it can be difficult to implant stent grafts without reducing vertebral or carotid artery blood flow. So, we used the kissing stent technique to maintain the blood flow of the right subclavian and carotid arteries as well as prevent a type 1 endoleak (a persistent perigraft channel of blood flow caused by inadequate seal at either the proximal or the distal stent graft end or attachment zones), 12 as in Figure 1. In the patient who received kissing stents, the diameter of the innominate artery, right common carotid artery and right subclavian artery were 12.0, 7.1 and 8.7 mm, respectively.…”

Section: Discussionmentioning

confidence: 99%

Endovascular repair of subclavian artery aneurysms: results from a single-center experience

Gao

et al. 2017

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“…Till now, SKS has been rarely used in the treatment of subclavian stenosis or occlusion. Li et al [6] reported 1 case using the SKS technique for the treatment of a subclavian artery aneurysm. In most cases of right subclavian stenosis, stenting in the single artery would be sufficient.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Kissing Stenting: A Valuable Technique for Reconstructing the Stenotic Initial Segment of the Right Subclavian Artery

et al. 2017

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Atherosclerotic stenosis or occlusion often involves the subclavian artery. For lesions that are close to the orifice of the right subclavian artery, stenting of the right subclavian artery itself blocks the pathway from the innominate artery to the right carotid artery and causes problems in patients with multiple angiostenosis, especially involving the right carotid system. In this study, we report 2 cases using simultaneous kissing stenting (SKS) of the right subclavian artery and the right carotid artery to relieve right subclavian stenosis and maintain right carotid system patency. Standard stenting methods were used to perform SKS. Two self-expanding stents were implanted simultaneously into the initial segment of the right subclavian artery and the right carotid artery, forming a “Y” shape, with the overlap of the proximal segments in the innominate artery ≥5 mm. After SKS, the stenosed right subclavian artery was dilated, and the patency of the right carotid system was maintained. The symptoms of patients were relieved and the stents were intact at several months of follow-up. In conclusion, SKS of the right subclavian artery and the right carotid artery might be a safe and effective procedure when the stenotic or occlusive lesion in the initial segment of the right subclavian artery is close to the orifice, and lesions (or potential ones) exist in the right carotid system.

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Simultaneous Kissing Stent Technique with Stent Grafts for Subclavian Artery Aneurysm: A Case Report

Cited by 7 publications

References 12 publications

Long-term outcomes of endovascular treatment of isolated subclavian artery aneurysms

Long-term outcomes of endovascular treatment of isolated subclavian artery aneurysms

Endovascular repair of subclavian artery aneurysms: results from a single-center experience

Simultaneous Kissing Stenting: A Valuable Technique for Reconstructing the Stenotic Initial Segment of the Right Subclavian Artery

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