Civilini E, Melissano G, Baccellieri D, Chiesa R
Scientific Institute H. San Raffaele, Vita-Salute University-School of Medicine, Via Olgettina 60, 20132 Milan, Italy.
Eur J Vasc Endovasc Surg. 2007 Aug;34(2):214-6. doi: 10.1016/j.ejvs.2007.04.004. Epub 2007 May 21.
Stent migrations are described after peripheral endovascular treatments. We report a case of an unusual iliac stent movement after a successful angioplasty.
An occlusive distal intimal flap after aorto-iliac endoarterectomy was successfully fixed by stenting of the left external iliac artery. One month later, the patient was readmitted due to contralateral limb acute ischemia. Angiography revealed a right iliac artery thrombosis due to upstream stent migration from the left external iliac artery into the right common iliac artery. The patient underwent a combined surgical and endovascular rescue technique.
Turbulent and pulsatile flow, associated with wall remodelling may explain this unexpected complication.
外周血管腔内治疗后有支架移位的相关报道。我们报告一例成功血管成形术后出现的罕见髂动脉支架移位病例。
腹主动脉-髂动脉内膜切除术后远端闭塞性内膜瓣通过左髂外动脉支架置入成功修复。1个月后,患者因对侧肢体急性缺血再次入院。血管造影显示右髂动脉血栓形成,原因是支架从左髂外动脉向上游移位至右髂总动脉。患者接受了外科手术与血管腔内抢救联合治疗。
与血管壁重塑相关的湍流和搏动血流可能解释了这一意外并发症。