Placement of abdominal aortic stent & placement of bilateral common iliac stents

nlbarnes

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POSTOPERATIVE DIAGNOSIS:
Bilateral lower extremity claudication bordering on rest pain.

PROCEDURES:
1. Abdominal aortogram and pelvic angiogram.
2. Placement of abdominal aortic stent and placement of bilateral
common iliac stents in kissing stent fashion.

The aortic stents were:
1.
a. 10 x 57 balloon expandable Visi-Pro stent.
b. Aortic stent 10 x 37 Visi-Pro.
2. Right common iliac stent, 7 x 57 Visi-Pro.
3. Left common iliac stent, 7 x 37 Visi-Pro.

DESCRIPTION OF PROCEDURE:
We accessed the bilateral common femoral arteries under ultrasound
guidance with a micropuncture needle. Micropuncture wire was advanced
into the external iliac artery and exchanged for a 0.035 guidewire. A
6-French sheath was then placed. Similar process was used
bilaterally. Ultrasound images were taken.

At that point, we used a SOS Omniflush catheter and angled Glidewire to
navigate the common iliac and abdominal aorta. We placed our flush catheter
into the distal aorta and performed abdominal aortogram.

Abdominal aortogram revealed absent left renal artery, patent right
renal artery, patent superior mesenteric artery, multilevel severe
stenosis of the abdominal aorta, bilateral common iliac artery
stenosis, diminutive yet patent external iliac arteries, absent
bilateral hypogastric arteries, patent common femoral artery, patent
proximal SFA and profunda femoris arteries.

At that point, we then heparinized the patient to an ACT of greater
than 250. We then started by placing our proximal aortic stent, which
was a 10 mm diameter x 57 mm length balloon expandable stent, this
landed just below the right renal artery with excellent result. We
then extended this with a 10 mm x 37 mm balloon expandable stent,
which extended just above the aortic bifurcation. We then placed
simultaneous 7 x 57 right common iliac artery stent and 7 x 37 left
common iliac stent, this was placed up into the distal portion of the
distal most aortic stent and deployed simultaneously in standard
kissing stent fashion. The flow through the abdominal aorta into the

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