REGULAR CONTENT
Final ID
666
Type
Educational Exhibit-Poster Only
Authors
M Khaja1, J Chick1, A Schuman1, K Cooper1, D Williams1
Institutions
1University of Michigan, Ann Arbor, MI
Purpose
To report results of fluoroscopic targeting of Wallstents and Amplatzer vascular plugs in sharp recanalization of chronic venous occlusions.
Materials & Methods
Wallstent and Amplatzer vascular plug (AVP) targeting was performed in 15 patients (8 females; mean age 50 years) from October 2015 until September 2016. 8 (53%) patients presented with venous occlusions in the upper extremity or superior vena cava and 7 (47%) had occlusions in the lower extremity or inferior vena cava. 11 (73%) presented with symptomatic venous occlusion characterized by swelling and pain and 4 (27%) required recanalization prior to pacemaker lead exchange. Once the chronic venous occlusion could not be traversed, sharp recanalization was employed. Instead of targeting a snare, however, a Wallstent or AVP was partially deployed and targeted using a transseptal needle under rotational fluoroscopy. This technique was used in the iliocaval (7), brachiocephalic/SVC (6), and upper extremity (2) segments in regions of multiple critical vascular structures. When targeting had been achieved and the device punctured, a wire was advanced into the punctured device and the Wallstent or AVP was retracted into its deployment sheath. Targeted device, technical success, procedural success, complications, and follow-up were recorded.
Results
A Wallstent was targeted in 13 (85%) and an AVP in 2 (15%). Technical success was achieved in all patients. Procedural success, defined as successful recanalization and stenting, was achieved in 14 (93%) patients. There were no immediate complications directly related to targeting using Wallstents or AVPs. 1 (17%) patient developed a retroperitoneal hematoma 5 cm rostral to the iliocaval confluence and required covered stent placement. Follow-up imaging was available in 6 (40%) patients and demonstrated patency of all recanalized and stented veins. Mean follow-up time in those 6 was 2.9 months (range: 0.5-6 months).
Conclusions
Fluoroscopic targeting of Wallstents and AVPs is a useful technique in sharp recanalization of chronic venous occlusions in regions with multiple adjacent critical vascular structures and is associated with few complications.
Final ID
666
Type
Educational Exhibit-Poster Only
Authors
M Khaja1, J Chick1, A Schuman1, K Cooper1, D Williams1
Institutions
1University of Michigan, Ann Arbor, MI
Purpose
To report results of fluoroscopic targeting of Wallstents and Amplatzer vascular plugs in sharp recanalization of chronic venous occlusions.
Materials & Methods
Wallstent and Amplatzer vascular plug (AVP) targeting was performed in 15 patients (8 females; mean age 50 years) from October 2015 until September 2016. 8 (53%) patients presented with venous occlusions in the upper extremity or superior vena cava and 7 (47%) had occlusions in the lower extremity or inferior vena cava. 11 (73%) presented with symptomatic venous occlusion characterized by swelling and pain and 4 (27%) required recanalization prior to pacemaker lead exchange. Once the chronic venous occlusion could not be traversed, sharp recanalization was employed. Instead of targeting a snare, however, a Wallstent or AVP was partially deployed and targeted using a transseptal needle under rotational fluoroscopy. This technique was used in the iliocaval (7), brachiocephalic/SVC (6), and upper extremity (2) segments in regions of multiple critical vascular structures. When targeting had been achieved and the device punctured, a wire was advanced into the punctured device and the Wallstent or AVP was retracted into its deployment sheath. Targeted device, technical success, procedural success, complications, and follow-up were recorded.
Results
A Wallstent was targeted in 13 (85%) and an AVP in 2 (15%). Technical success was achieved in all patients. Procedural success, defined as successful recanalization and stenting, was achieved in 14 (93%) patients. There were no immediate complications directly related to targeting using Wallstents or AVPs. 1 (17%) patient developed a retroperitoneal hematoma 5 cm rostral to the iliocaval confluence and required covered stent placement. Follow-up imaging was available in 6 (40%) patients and demonstrated patency of all recanalized and stented veins. Mean follow-up time in those 6 was 2.9 months (range: 0.5-6 months).
Conclusions
Fluoroscopic targeting of Wallstents and AVPs is a useful technique in sharp recanalization of chronic venous occlusions in regions with multiple adjacent critical vascular structures and is associated with few complications.