Endovascular stenting for stenoses in surgically reconstructed brachiocephalic bypass grafts: Immediate and midterm outcomes

Angelo Anzuini, Roberto Chiesa, Krishnamoorthy Vivekananthan, Barry Uretsy, Antonio Colombo, Alberto Margonato, Flavio Airoldi, Salvatore Rosanio, Giuseppe Augello, Yochai Birnbaum, Giuseppe Magnani, Gloria Esposito, Germano Melissano, Marcelo R L Moura, Carlo Briguori

Research output: Contribution to journalArticle

Abstract

Purpose: To report the use of endovascular stenting for treatment of patients with symptomatic obstruction of brachiocephalic surgical reconstructions. Methods: Twenty-two patients (17 men; mean age 65±6 years) with 24 symptomatic obstructions of brachiocephalic Dacron bypass grafts (2 aorto-innominate, 9 subclavian-carotid, and 11 carotid-subclavian) were treated with balloon-expandable stents delivered via a percutaneous brachial access or surgical exposure of the common carotid artery. A distal protection device was utilized in the 9 patients with subclavian-carotid bypass grafts. All patients were followed by clinical and Doppler examinations. Results: Procedural success was 100%; 1 (4.5%) patient developed transient intraprocedural aphasia owing to intolerance to the distal protection balloon occlusion. All 22 patients reported complete relief of their presenting symptoms. Over a 29-month follow-up, 3 (13.6%) restenoses were found, but none was due to stent compression. Conclusions: Stenting for obstructed brachiocephalic reconstructions appears to be a safe, effective, and durable therapeutic strategy.

Original languageEnglish
Pages (from-to)263-268
Number of pages6
JournalJournal of Endovascular Therapy
Volume11
Issue number3
DOIs
Publication statusPublished - Jun 2004

Keywords

  • Bypass graft
  • Common carotid artery
  • Graft failure
  • Innominate artery
  • Palmaz stent
  • Stent
  • Subclavian artery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Anzuini, A., Chiesa, R., Vivekananthan, K., Uretsy, B., Colombo, A., Margonato, A., Airoldi, F., Rosanio, S., Augello, G., Birnbaum, Y., Magnani, G., Esposito, G., Melissano, G., Moura, M. R. L., & Briguori, C. (2004). Endovascular stenting for stenoses in surgically reconstructed brachiocephalic bypass grafts: Immediate and midterm outcomes. Journal of Endovascular Therapy, 11(3), 263-268. https://doi.org/10.1583/03-1111.1