The aim of the study was to present our own endovascular treatment results in cases of patients suffering from symptomatic stenosis of the brachiocephalic trunk.Material and methods. During the period between March 2000 and October 2004, 14 patients underwent angioplasty accompanied by stent implantation. The above-mentioned procedure was performed, due to critical, symptomatic stenosis of the brachiocephalic trunk. The patients were diagnosed and placed into different procedural groups based on the physical examination and radiological imaging examinations (Doppler ultrasound and DSA). The immediate and long-term results were evaluated with the physical examination and Doppler ultrasound examination performed at 3-, 6- and 12-months after the procedure.Results. In every patient, the immediate results were positive. Intraoperative DSA angiography confirmed that the artery was dilated. Preoperative clinical symptoms of cerebral and collateral circulation insufficiency in the upper extremity were limited (5/14) or totally regressed (9/14) during the postoperative period. During the intra- and postoperative period, none of the following complications were found: upper extremity arterial embolism, acute arterial thrombosis, dissection or rupture of the brachiocephalic trunk wall, or death. Patients were discharged 2 or 3 days following the procedure. Follow-up examinations confirmed proper blood flow in the brachiocephalic trunk and increased flow in the right vertebral artery. No symptoms of restenosis were found in the area of stent implantation and the stent was not dislocated.Conclusions. Angioplasty accompanied by stent implantation is a safe and efficient treatment method in the case of patients suffering from symptomatic stenosis of the brachiocephalic trunk, particularly in patients with significant operative risk. The hypothesis was confirmed by both perioperative observations and immediate, as well as, long-term patency results.
Currently, there are two methods of stentgraft implantation considering patients with abdominal aortic aneurysms (AAA) undergoing endovascular repair: the suprarenal and infrarenal fixation. It has been suggested that suprarenal fixation may lead towards impaired kidney function.The aim of the study was to assess the influence of suprarenal stentgraft fixation on kidney function in patients after endovascular repair of abdominal aortic aneurysms.Material and methods. The inclusion criteria were fulfilled by 118 patients who were subjected to endovascular treatment, due to abdominal aortic aneurysms. They were consequently divided into two groups - suprarenal (NN) or infrarenal (PN) - based on the stentgraft system used. Both groups were compared on the basis of co-morbidities, operative risk (ASA score), and volume of contrast medium used intraoperatively. The creatinine concentration (cr) and creatinine clearance (Cr.cl) were assessed during the preoperative period, between the 3-rd and 7-th postoperative day, and after 3 months.Results. Increased creatinine level during the first postoperative week was observed in 12 of 118 patients (10.1%): in the suprarenal group - 7 of 66 (10.6%), and in the infrarenal group 5 of 52 (9.96%). During the 3-rd postoperative month the increase (cr > 1.5 mg/dL) was present in 3 of 118 patients (2.5%): in the suprarenal group - 2 of 66 (3.03%) and in the infrarenal group-1 of 52 (1.9%). The difference between both groups was statistically insignificant. Furthermore, there was no statistically significant difference between creatinine clearance levels considering both groups.Conclusions. In case of patients undergoing endovascular repair for AAA, implantation of a suprarenal device is a safe method, which does not significantly impair postoperative renal functioning. This increases the number of patients eligible for AAA treatment by means of stentgraft implantations.