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AAA rupture after EVT of ILIAC-CTO
Yoshinori TSUBAKIMOTO, M.D., Ph.D.Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, JAPAN
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Disclosure
Speaker name: Yoshinori TSUBAKIMOTO , M.D., Ph.D.
.................................................................................
I have the following potential conflicts of interest to report:
Consulting
Employment in industry
Stockholder of a healthcare company
Owner of a healthcare company
Other(s)
I do not have any potential conflict of interest✓
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Case
Patient: 52 year-old male
Diagnosis: PAD (Rutherford class 2)
Past history: Type B aortic dissection, ESRD on HD
Risk factor: Hypertension, HD
ABI: 0.55
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Initial angiography
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IVUS guided wiring
EVT for Rt.CIA-CTO
Wire crossing
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POBA 2.0mm
IVUS pull-back IVUS images
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IVUS guided parallel rewiring
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IVUS pull-back IVUS images
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Pre-dilatation Assurant Cobalt 8.0x30mm
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Completion angiography
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CT images 3 hours after the EVT
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Emergent angiography
Courtesy of Dr. Akimitsu TANAKA from Nagoya Tokusyukai General Hospital
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Rescue balloon Fluency
Courtesy of Dr. Akimitsu TANAKA
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ExcluderMain body
Residual extravasation
Courtesy of Dr. Akimitsu TANAKA
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ExcluderRt.leg
ExcluderLt.leg
Courtesy of Dr. Akimitsu TANAKA
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Completion angiography
Courtesy of Dr. Akimitsu TANAKA
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✓We performed EVT for a claudicant patient with Rt. CIA-CTO, who had a past history of type B Aortic dissection.
✓ Unfortunately, the 1st GW (0.014 inch) crossed the CTO through a subintimal space which might be made at the time of previous Aortic dissection.
✓ The subintimal space was dilated by 2.0mmballoon to check the IVUS.
Summary 1
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✓ Several hours after the procedure, AAA was ruptured. Emergent EVAR was required to bail out this complication.
Summary 2
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✚ Japanese Red Cross Kyoto Daini Hospital
Thank You for your attention !!