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In vivo construction of a multilayer bare-metal stent for the treatment of an aortic mycotic pseudoaneurysm  S. Lowell Kahn, MD, MBA, Syed Peeran, MD,

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Presentation on theme: "In vivo construction of a multilayer bare-metal stent for the treatment of an aortic mycotic pseudoaneurysm  S. Lowell Kahn, MD, MBA, Syed Peeran, MD,"— Presentation transcript:

1 In vivo construction of a multilayer bare-metal stent for the treatment of an aortic mycotic pseudoaneurysm  S. Lowell Kahn, MD, MBA, Syed Peeran, MD, Sara Smolinski, MD, Marc Norris, MD, Sang W. Rhee, MD, Jeffrey Kaufman, MD  Journal of Vascular Surgery  Volume 62, Issue 3, Pages (September 2015) DOI: /j.jvs Copyright © 2015 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Example of a physician-created multilayer stent using three concentrically placed Wallstents (Boston Scientific, Natick, Mass). Note the slight elongation of the innermost stent secondary to constriction by the first two stents. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

3 Fig 2 A, Axial computed tomography (CT) scan obtained immediately before repair of an aortic mycotic pseudoaneurysm. Previous serial CTs (not shown) demonstrated progressive enlargement over the course of a week. B, Oblique coronal aortogram obtained immediately after the placement of three concentric Wallstents (Boston Scientific, Natick, Mass). Note the main pseudoaneurysm located below the renal arteries (solid black arrow) and the smaller pseudoaneurysm located more inferiorly (dashed arrow). Immediately after deployment of the concentric stents, the multilayer stent produced sluggish flow in both pseudoaneurysms, appreciated on real-time imaging. This is hypothesized to represent a depressurization effect on the pseudoaneurysms because laminar flow within the stent lumen is facilitated. Also note the preservation of blood flow into the inferior mesenteric artery (right angle arrow) and a lumbar artery (curved arrow). The proximal extent of the stents is at the left renal artery, ∼1 cm cephalad to the uppermost mark on the pigtail catheter. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Axial computed tomography (CT) scans obtained at (A) 3, (B) 6, and (C) 16 months after the procedure. Note the progressive resolution of the mycotic pseudoaneurysm (arrows in B and C) until there is complete resolution by 16 months. There is persistent patency of at least one lumbar artery and the inferior mesenteric artery (arrow in A). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

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