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Iatrogenic Subclavian Artery Perforation Rescued by Operator-Modified Graft Sent
Chih-Hung Lai,Wen-Lieng Lee,Chung-Lin Tsai,Wei-Chun Chang,Chieh-Shou Su 연세대학교의과대학 2017 Yonsei medical journal Vol.58 No.2
Subclavian artery (SCA) perforation is a rare complication while performing SCA intervention. In our present report, a 73-year-old female, with stenosis of the left SCA and situs inversus, presented with exercise-induced left arm weakness. The SCA stenosis was treated with direct stenting with a balloon-expansible Express LD 10×25 mm stent. However, it caused iatrogenic SCA perforationand hemothorax. The perforation was sealed by endovascular repair with operator-modified Endurant II graft stent, which complicated with occlusion of left common carotid artery. And, the carotid artery was rescued by another stent. The graft stent, which was originally designed for abdominal aortic aneurysm, can be modified to suitable length and take as a rescue stent of large vessel with iatrogenic perforation. Due to strong radial force of graft stent, preservation of large side branches should been watched out.
Coronary Stent Infection Presented as Recurrent Stent Thrombosis
Chih-Hung Lai,Wei-Chun Chang,Yung-Kai Lin,Wen-Lieng Lee 연세대학교의과대학 2017 Yonsei medical journal Vol.58 No.2
Percutaneous transluminal coronary angioplasty with metal stent placement has become a well-developed treatment modality for coronary stenotic lesions. Although infection involving implanted stents is rare, it can, however, occur with high morbidity and mortality. We describe herein a case of an inserted coronary stent that was infected and complicated with recurrent stent thrombosis, pseudoaneurysm formation and severe sepsis. Despite repeated intervention and bypass surgery, the patient died from severe sepsis.