Percutaneous treatment of catheter-induced traumatic peripheral arterial lesions with dacron-covered nitinolstents

Objective: Percutaneous peripheral interventional procedures as well as cor onary interventions can be complicated by dissections and traumatic lesions of peripheral arteries. The aim of this study was to evaluate the efficacy of fabric covered endoprostheses for percutaneous repair of traumatic peri pheral arterial lesions. Patients and methods: In this study we used the EndoPro 1/Pas sager device (Boston Scientific, USA), which is a self-expanding nitinol stent covered b y an ultrathin layer of dacron fabric. In 27 patients a total number of 31 endoprostheses (mean length 7.3 cm) were implanted in iliac (n = 20), femor al (n = 6) and popliteal arteries (n = 1). Indications for stenting were la rge dissections (n = 24), arterial perforations (n = 2) and one traumatic a rterio-venous fistula. Results: An immediate exclusion of the lesion could be achieved in all case s. There were no major procedural complications. However, within 24 hours a fter implantation 14 patients (51.9 %) developed fever. WBC and CRP were el evated in 13 (48.1 %) and 17 (63 %) patients, respectively. Repeated blood cultures could not show any bacterial growth. The primary patency after a m ean follow-up of 19 (5 to 31) months was 85.2 %. In two cases with markedly impaired peripheral runoff subacute graft occlusions occurred. In 2 other cases the angiography revealed relevant restenoses (>75 %). The patency cou ld be restored in 2 of these 4 cases leading to a secondary patency rate of 92.6 %. Conclusions: The EndoPro 1/Passager endoprosthesis seems to be safe and eff ective to seal large dissections and traumatic lesions of peripheral arteri es, showing a high long-term patency rate.