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Title: Endovascular Treatment of Multiple HIV-related Aneurysms Using Multilayer Stents

Abstract

Complex peripheral aneurysm anatomy with major artery branches in the immediate vicinity and mycotic aneurysm often impede endovascular management using covered stent grafts. The Cardiatis Multilayer Stent (Cardiatis, Isnes, Belgium) is a recently approved innovative stent system for peripheral aneurysm management. Its multilayer design aims at decreasing mean velocity and vorticity within the aneurysm sac to cause thrombus formation while maintaining patency of branching vessels due to laminar flow. We present a case of bilateral subclavian artery aneurysms and perivisceral aortic aneurysms in an AIDS patient successfully treated with the Cardiatis Multilayer Stent at 18 months' follow-up.

Authors:
 [1]; ;  [2];  [1]
  1. University Hospital Freiburg, Department of Diagnostic Radiology (Germany)
  2. University Hospital Freiburg, Department of Cardiovascular Surgery (Germany)
Publication Date:
OSTI Identifier:
22066586
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 35; Journal Issue: 4; Other Information: Copyright (c) 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; AIDS; AIDS VIRUS; ANATOMY; ARTERIES; GRAFTS; PATIENTS; RADIOLOGY

Citation Formats

Euringer, Wulf, Suedkamp, Michael, Rylski, Bartosz, and Blanke, Philipp, E-mail: philipp.blanke@uniklinik-freiburg.de. Endovascular Treatment of Multiple HIV-related Aneurysms Using Multilayer Stents. United States: N. p., 2012. Web. doi:10.1007/S00270-011-0269-9.
Euringer, Wulf, Suedkamp, Michael, Rylski, Bartosz, & Blanke, Philipp, E-mail: philipp.blanke@uniklinik-freiburg.de. Endovascular Treatment of Multiple HIV-related Aneurysms Using Multilayer Stents. United States. doi:10.1007/S00270-011-0269-9.
Euringer, Wulf, Suedkamp, Michael, Rylski, Bartosz, and Blanke, Philipp, E-mail: philipp.blanke@uniklinik-freiburg.de. 2012. "Endovascular Treatment of Multiple HIV-related Aneurysms Using Multilayer Stents". United States. doi:10.1007/S00270-011-0269-9.
@article{osti_22066586,
title = {Endovascular Treatment of Multiple HIV-related Aneurysms Using Multilayer Stents},
author = {Euringer, Wulf and Suedkamp, Michael and Rylski, Bartosz and Blanke, Philipp, E-mail: philipp.blanke@uniklinik-freiburg.de},
abstractNote = {Complex peripheral aneurysm anatomy with major artery branches in the immediate vicinity and mycotic aneurysm often impede endovascular management using covered stent grafts. The Cardiatis Multilayer Stent (Cardiatis, Isnes, Belgium) is a recently approved innovative stent system for peripheral aneurysm management. Its multilayer design aims at decreasing mean velocity and vorticity within the aneurysm sac to cause thrombus formation while maintaining patency of branching vessels due to laminar flow. We present a case of bilateral subclavian artery aneurysms and perivisceral aortic aneurysms in an AIDS patient successfully treated with the Cardiatis Multilayer Stent at 18 months' follow-up.},
doi = {10.1007/S00270-011-0269-9},
journal = {Cardiovascular and Interventional Radiology},
number = 4,
volume = 35,
place = {United States},
year = 2012,
month = 8
}
  • Endovascular treatment for a wide-neck anterior communicating artery (AcomA) aneurysm remains technically challenging. Stent-assisted embolization has been proposed as an alternative of treatment of complex aneurysms. The X-configuration double-stent-assisted technique was used to achieve successful coiling of wide-neck AcomA aneurysm. Implanted stent can alter intra-arterial flow. Follow-up angiograms 4 months later showed flow changes due to used X-technique of stents implantation and filling of the anterior cerebral artery from the opposite internal carotid artery.
  • Since its approval as an innovative stent system for peripheral aneurysm management in May 2009, the Cardiatis Multilayer Stent (Cardiatis, Isnes, Belgium) has been applied in several clinical cases. The unique design of this multilayer stent decreases mean velocity and vorticity within the aneurysm sac immediate and causes thrombus to form, resulting in physiological exclusion of the aneurysm from the circulation, whereas branches and collaterals sprouting from the aneurysm remain patent. Here we present a case of a complex renal artery aneurysm successfully treated with a 6 Multiplication-Sign 30-mm Cardiatis Multilayer Stent.
  • Aneurysms of the extracranial internal carotid artery (EICA) are infrequent. They are difficult to treat with conventional surgery because of their distal extension into the skull base. We report three cases of EICA aneurysms in two symptomatic patients successfully treated with polytetrafluoroethylene self-expanding endografts using an endovascular approach. The aneurysms were located distal to the carotid bifurcation and extended to the subpetrous portion of the internal carotid artery.
  • Bronchial artery dilatation and aneurysm formation is a potential complication of local inflammation, especially in bronchiectasis. When the bronchial artery has an ectopic origin from the inferior segment of the aortic arch, aneurysms may mimick aortic aneurysms. Despite this particular location, endovascular treatment is possible. We report two such aneurysms that were successfully embolized with steel coils.
  • Purpose: To assess the endovascular treatment of splenic artery aneurysms and false aneurysms. Methods: Twelve patients (mean age 59 years, range 47-75 years) with splenic artery aneurysm (n = 10) or false aneurysm (n = 2) were treated. The lesion was asymptomatic in 11 patients; hemobilia was observed in one patient. The lesion was juxta-ostial in one case, located on the intermediate segment of the splenic artery in four, near the splenic hilus in six,and affected the whole length of the artery in one patient. In 10 cases, the maximum lesion diameter was greater than 2 cm; in one casemore » 30% growth of an aneurysm 18 mm in diameter had occurred in 6 months;in the last case, two distal aneurysms were associated (17 and 18 mm in diameter). In one case, stent-grafting was attempted; one detachable balloon occlusion was performed; the 10 other patients were treated with coils. Results: Endovascular treatment was possible in 11 patients (92%) (one failure: stenting attempt). In four cases among 11, the initial treatment was not successful (residual perfusion of aneurysm); surgical treatment was carried out in one case, and a second embolization in two. Thus in nine cases (75%) endovascular treatment was successful: complete and persistent exclusion of the aneurysm but with spleen perfusion persisting at the end of follow-upon CT scans (mean 13 months). An early and transient elevation of pancreatic enzymes was observed in four cases. Conclusion: Ultrasound and CT have made the diagnosis of splenic artery aneurysm or false aneurysm more frequent. Endovascular treatment, the morbidity of which is low, is effective and spares the spleen.« less