Preliminary experience with new generation balloon expandable stent-graft in the treatment of innominate artery obstructive disease.

Abstract

Background: The aim of this study was to describe a single center preliminary experience with the use of a specific balloon expandable stent-graft for the treatment of innominate artery (IA) obstructive lesions.

Methods: We report our experience with four male patients treated with Gore Viabahn balloon (Gore Medical, Flagstaff, AZ, USA) expandable stent-graft for different types of IA stenosis: three patients were symptomatic for vertebrobasilar insufficiency, while one patient was asymptomatic for cerebrovascular symptoms. The stent grafts were deployed using retrograde (N.=2) or antegrade approach (N.=2), aiming to cover the entire lesions length and to slightly protrude into the aortic arch. Post-dilatation was performed with a compliant balloon. One patient presented a tandem lesion (IA and right internal carotid artery) and after the stenting of the IA he was treated also with a carotid artery stenting during the same procedure.

Results: Technical success was achieved in all patients. No perioperative or postoperative complications had been reported and the neurological disorders disappeared for the three symptomatic patients. After a mean clinical and radiological follow-up of 24±5 months, all the stents were patent and perfectly adapted to the vessels.

Conclusions: This preliminary clinical experience shows that the use of the Gore Viabahn balloon (Gore Medical) expandable stent-graft seems safe and feasible for the treatment of the IA obstructive lesions, also in presence of irregular plaques and hostile anatomies for an endovascular treatment. Larger experiences and long-term data are mandatory.