Aim
It is aimed to present the endovascular treatment of a patient with multiple arterial lesions with angiography images.
Case
A 53-year-old male patient was referred to our interventional radiology unit with fatigue and numbness in both arms, pain in the right groin and claudication in the right leg for the diagnosis and treatment. Pelvic arteriography showed a double lumen in the right main iliac artery, consistent with dissection approximately in 5 cm segment, and treated with balloon expandable stent. The inferior mesenteric artery was found to be extremely wide at the level of the distal abdominal aorta and mesenteric arteriography was performed. Preocclusive stenosis in the celiac trunk, total occlusion in the origin of the superior mesenteric artery and a large arc of Riolan were detected. Diagnostic upper extremity angiography revealed total occlusion in the left subclavian artery just distal to the origin, total occlusion of 6 cm in length in the right subclavian artery after the origin of the vertebral artery and severe stenosis in the origin of the right vertebral artery. Both upper extremity arteries were filled by collaterals after the occlusions and the distal of the left subclavian artery was retrogradely filled by vertebral artery (left subclavian steal syndrome). In the next session, occluded segments in both subclavian arteries and stenosis in the origin of the right vertebral artery were treated with balloon expandable stents. Also, total occlusion in the origin of the right internal carotid artery and filling of the right middle and anterior cerebral arteries by collateral circulation from the opposite side through the anterior communicating artery was detected in control angiograms
Discussion
Endovascular techniques in the treatment of peripheral vascular diseases are increasingly replacing surgical treatment in recent years. Angioplasty and stenting aim to improve the quality of life of patients by protecting the organ/extremity functions or by regaining functions. Complications reported by endovascular techniques vary according to the comorbidities of patients but are lower than in conventional surgical treatments.
Conclusion
With the advancing technology, the quality and diversity of the existing materials, the increasing number of centers and experience, the endovascular treatment of arterial occlusion and stenosis are preferred with less invasive nature and low complication rates.
Keywords: Endovascular, Artery, Stent, Percutaneous Transluminal Angioplasty
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