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The ViaHole technique: a novel approach for recanalizing major side branch occluded by Viabahn stent-graft
INTRODUCTION: In managing arterial rupture, stent-graft implantation may cause limb ischemia by crossing a major branch for hemostasis. The ViaHole technique could circumvent a major branch occlusion. MATERIALS AND METHODS: The process involved advancing retrograde devices into an occluded major bra...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349792/ https://www.ncbi.nlm.nih.gov/pubmed/37452921 http://dx.doi.org/10.1186/s42155-023-00385-8 |
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author | Haraguchi, Takuya Tsujimoto, Masanaga Otake, Ryo Kashima, Yoshifumi Sato, Katsuhiko Fujita, Tsutomu |
author_facet | Haraguchi, Takuya Tsujimoto, Masanaga Otake, Ryo Kashima, Yoshifumi Sato, Katsuhiko Fujita, Tsutomu |
author_sort | Haraguchi, Takuya |
collection | PubMed |
description | INTRODUCTION: In managing arterial rupture, stent-graft implantation may cause limb ischemia by crossing a major branch for hemostasis. The ViaHole technique could circumvent a major branch occlusion. MATERIALS AND METHODS: The process involved advancing retrograde devices into an occluded major branch by the stent-graft implantation to reach the outer surface of the stent-graft, puncturing the stent-graft with a 20-gauge needle to touch the retrograde device, manipulating the guidewire through the needle hole and externalizing it, advancing the microcatheter into the proximal lumen, catching the microcatheter using an antegrade 4-Fr catheter, inserting an antegrade guidewire into the retrograde microcatheter to cross the stent-graft hole, dilating the lesion and stent-graft hole using a 3.0-mm balloon, and ensuring hemostasis at the puncture site. RESULTS: A 72-year-old male with a history of stent-grafted treatment for right popliteal aneurysm presented with acute limb ischemia (ALI). The occlusion spanned distal superficial femoral artery to the below-the-knee arteries. Hemostasis was achieved after an unintentional rupture of the proximal posterior tibial artery during surgical thrombectomy by implanting endoluminal stent-grafts instead of surgical bypass due to no distal anastomosis site. However, recurrent ALI occurred three months later. Surgical bypass was again deemed unfeasible due to no run-off. Unsuccessful recanalization attempts of the bilateral tibial arteries led us to perform the ViaHole technique to recanalize the peroneal artery occlusion. Finally. successful revascularization was achieved, and 1-year patency was confirmed. CONCLUSIONS: The ViaHole technique may be valuable for revascularizing a major side branch occluded by stent-graft implantation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s42155-023-00385-8. |
format | Online Article Text |
id | pubmed-10349792 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-103497922023-07-17 The ViaHole technique: a novel approach for recanalizing major side branch occluded by Viabahn stent-graft Haraguchi, Takuya Tsujimoto, Masanaga Otake, Ryo Kashima, Yoshifumi Sato, Katsuhiko Fujita, Tsutomu CVIR Endovasc New Technologies INTRODUCTION: In managing arterial rupture, stent-graft implantation may cause limb ischemia by crossing a major branch for hemostasis. The ViaHole technique could circumvent a major branch occlusion. MATERIALS AND METHODS: The process involved advancing retrograde devices into an occluded major branch by the stent-graft implantation to reach the outer surface of the stent-graft, puncturing the stent-graft with a 20-gauge needle to touch the retrograde device, manipulating the guidewire through the needle hole and externalizing it, advancing the microcatheter into the proximal lumen, catching the microcatheter using an antegrade 4-Fr catheter, inserting an antegrade guidewire into the retrograde microcatheter to cross the stent-graft hole, dilating the lesion and stent-graft hole using a 3.0-mm balloon, and ensuring hemostasis at the puncture site. RESULTS: A 72-year-old male with a history of stent-grafted treatment for right popliteal aneurysm presented with acute limb ischemia (ALI). The occlusion spanned distal superficial femoral artery to the below-the-knee arteries. Hemostasis was achieved after an unintentional rupture of the proximal posterior tibial artery during surgical thrombectomy by implanting endoluminal stent-grafts instead of surgical bypass due to no distal anastomosis site. However, recurrent ALI occurred three months later. Surgical bypass was again deemed unfeasible due to no run-off. Unsuccessful recanalization attempts of the bilateral tibial arteries led us to perform the ViaHole technique to recanalize the peroneal artery occlusion. Finally. successful revascularization was achieved, and 1-year patency was confirmed. CONCLUSIONS: The ViaHole technique may be valuable for revascularizing a major side branch occluded by stent-graft implantation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s42155-023-00385-8. Springer International Publishing 2023-07-15 /pmc/articles/PMC10349792/ /pubmed/37452921 http://dx.doi.org/10.1186/s42155-023-00385-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | New Technologies Haraguchi, Takuya Tsujimoto, Masanaga Otake, Ryo Kashima, Yoshifumi Sato, Katsuhiko Fujita, Tsutomu The ViaHole technique: a novel approach for recanalizing major side branch occluded by Viabahn stent-graft |
title | The ViaHole technique: a novel approach for recanalizing major side branch occluded by Viabahn stent-graft |
title_full | The ViaHole technique: a novel approach for recanalizing major side branch occluded by Viabahn stent-graft |
title_fullStr | The ViaHole technique: a novel approach for recanalizing major side branch occluded by Viabahn stent-graft |
title_full_unstemmed | The ViaHole technique: a novel approach for recanalizing major side branch occluded by Viabahn stent-graft |
title_short | The ViaHole technique: a novel approach for recanalizing major side branch occluded by Viabahn stent-graft |
title_sort | viahole technique: a novel approach for recanalizing major side branch occluded by viabahn stent-graft |
topic | New Technologies |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349792/ https://www.ncbi.nlm.nih.gov/pubmed/37452921 http://dx.doi.org/10.1186/s42155-023-00385-8 |
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