Abstract:
An 83-year-old woman with claudication in the right lower extremity was referred to our hospital. Since angiography showed severe stenosis with a severely calcified lesion extending from the ostial to proximal part of the right superficial femoral artery (SFA), endovascular therapy (EVT) with the Jetstream™ atherectomy system (Boston Scientific, Marlborough, MA, USA) and paclitaxel-coated balloon (PCB) was performed. Atherectomy was performed using the Jetstream™ atherectomy catheter SC 1.85, followed by an additional atherectomy using the Jetstream™ atherectomy catheter XC 2.1/3.0. Subsequently, angiography and intravascular ultrasound (IVUS) images showed the enlargement of lumen area due to the reduction of calcified plaque, but even some of the healthy media on the side free of calcified plaque had been removed. Next, a PCB dilation was performed, and the final angiography showed adequate dilation. However, the symptoms recurred 9 months after EVT. Angiography revealed an enlarged vessel suggestive of pseudoaneurysm at the ostial part of the right SFA and severe stenosis distal to the enlarged vessel. IVUS images showed a pseudoaneurysm and severe stenosis due to calcified nodules distal to the pseudoaneurysm. This case suggests that pseudoaneurysm is a potential complication of EVT with the Jetstream™ atherectomy system and PCB for SFA lesions.
UNASSIGNED: The Jetstream™ atherectomy system (Boston Scientific, Marlborough, MA, USA) has developed to improve outcomes for femoropopliteal artery lesions with severely calcified lesions in lower extremity arterial disease by removing calcified plaque and improving vascular compliance. Several clinical reports demonstrated durable patency rates and low complication rates after endovascular therapy using the atherectomy device. However, pseudoaneurysm is a potential complication of endovascular therapy with the Jetstream™ atherectomy system.
摘要:
一名83岁的右下肢跛行妇女被转诊到我们医院。由于血管造影显示严重狭窄,并有严重钙化的病变,从右股浅动脉(SFA)的开口延伸到近端,使用Jetstream™动脉粥样硬化系统进行血管内治疗(EVT)(波士顿科学,马尔伯勒,MA,美国)和紫杉醇涂层球囊(PCB)进行。使用Jetstream™旋切术导管SC1.85进行旋切术,随后使用Jetstream™旋切术导管XC2.1/3.0进行额外的旋切术。随后,血管造影和血管内超声(IVUS)图像显示,由于钙化斑块的减少,管腔面积扩大,但即使是一些没有钙化斑块的健康介质也已被清除。接下来,进行了PCB扩张,最后的血管造影显示足够的扩张。然而,EVT后9个月症状复发。血管造影显示血管增大,提示右SFA口部分有假性动脉瘤,并在增大血管远端严重狭窄。IVUS图像显示假性动脉瘤和严重狭窄,这是由于假性动脉瘤远端钙化结节所致。这种情况表明假性动脉瘤是使用Jetstream™粥样斑块切除术系统和PCB治疗SFA病变的EVT的潜在并发症。
■Jetstream™旋切术系统(波士顿科学,马尔伯勒,MA,USA)已开发用于通过去除钙化斑块和改善血管顺应性来改善下肢动脉疾病中严重钙化病变的股pop动脉病变的预后。一些临床报告显示,使用粥样斑块切除装置进行血管内治疗后,通畅率持久,并发症发生率低。然而,假性动脉瘤是使用Jetstream™动脉粥样硬化切除术系统进行血管内治疗的潜在并发症。