Aneurysms of the upper extremity arteries are uncommon and may be difficult to manage with standard surgical techniques. We report the exclusion of three axillary-subclavian aneurysms with covered stents.
Methods and Results:
Palmaz stents were covered with either polytetrafluoroethylene (2 cases) or brachial vein and deployed to exclude pseudoaneurysms in 1 axillary (ruptured) and 2 left subclavian arteries. Two of the patients had advanced cancer and died within 52 days and 3 months of treatment, but their aneurysms were occluded at the time of their death. The repair in the third patient is patent at 9 months.
Conclusions:
Endovascular exclusion of axillary and subclavian aneurysms with covered stents may offer a useful alternative to operative repair, particularly in patients with significant comorbidities.
QueralLACriadoFJ. The treatment of focal aortic arch branch lesions with Palmaz stents. J Vasc Surg1996;23:368–375.
4.
SullivanTMBacharachJMChildsMB. PTA and primary stenting of the subclavian and innominate arteries. (Abstr.)Circulation1995;92:1–383.
5.
EllCHochenbergerJMayA. Coated and uncoated self-expanding metal stents for malignant stenosis in the upper Gl tract: Preliminary clinical experiences with Wallstents. Am J Gastroenterol1994;89:1496–1500.
6.
NishimineKSaxonRRKichikawaK. Improved transjugular intrahepatic portosystemic shunt patency with PTFE-covered stent-grafts: Experimental results in swine. (Abstr.)Radiology1995;196:341.
7.
KishiKKobayashiHSurudaT. Treatment of malignant tracheobronchial stenosis by Dacron mesh-covered stents. Cardiovasc Intervent Radiol1994;17:33–35.
8.
VolodosNLKarpovichIPTroyanVI. Clinical experience of the use of self-fixing synthetic prostheses for remote endoprosthetics of the thoracic and the abdominal aorta and iliac arteries through the femoral artery and as intraoperative endoprosthesis for aorta reconstruction. Vasa Suppl1991;33:93–95.
9.
ParodiJCPalmazJCBaroneHD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysm. Ann Vasc Surg1991;5:491–499.
10.
DakeMDMillerDCSembaCP. Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med1994;331:1729–1734.
11.
WhiteGHYuWMayJ. A new nonstented balloon-expandable graft for straight or bifurcated endoluminal bypass. J Endovasc Surg1994;1:16–24.
12.
RazaviMKDakeMDSembaCP. Percutaneous endoluminal placement of stent-grafts for the treatment of isolated iliac artery aneurysms. Radiology1995;197:801–804.
13.
BuiBTOlivaVLLeclercG. Renal artery aneurysm: Treatment with percutaneous placement of a stent-graft. (Abstr.)Radiology1995;195:181.
14.
MarinMLVeithFJPanettaTF. Transfemoral endoluminal stented graft repair of a popliteal artery aneurysm. (Abstr.)J Vasc Intervent Radiol1994;5:794.
15.
MayJWhiteGWaughR. Transluminal placement of a prosthetic graft-stent device for treatment of subclavian artery aneurysm. J Vasc Surg1993;18:1056–1059.
16.
MarstonWACriadoEMauroMA. Transbrachial endovascular exclusion of an axillary artery pseudoaneurysm with PTFE-covered stents. J Endovasc Surg1995;2:172–176.
17.
MarinMLVeithFJPanettaTF. Percutaneous transfemoral insertion of a stented graft to repair a traumatic arteriovenous fistula. J Vasc Surg1993;18:299–302.
18.
DorrosGJosephG. Closure of a popliteal arteriovenous fistula using an autologous vein-covered Palmaz stent. J Endovasc Surg1995;2:177–181.
19.
ToutouzasKStefanadisCVlachopoulosC. Coronary stenting using the autologous vein graft-covered stent: A novel technique for coronary intervention? (Abstr.)J Invasive Cardiol1996;8:58.
20.
HeuserRRReynoldsGTPapazoglouC. Endoluminal grafting for percutaneous aneurysm exclusion in an aortocoronary saphenous vein graft: The first clinical experience. J Endovasc Surg1995;2:81–88.
21.
ParodiJC. Endovascular repair of abdominal aortic aneurysms and other arterial lesions. J Vasc Surg1995;21:549–557.
22.
MossJGLabordeJCClemMC. Vascular occlusion with a balloon-expandable stent occluder. Radiology1994;191:483–486.
