Comparison shots before and after stent placement are shown. Pulses improved in the right lower extremity and symptoms were relieved.
Angiographers: James Rothstein, Donald Miller
Blue toe syndrome is due to distal showering of atheroemboli from an ulcerated plaque, in this case at the right iliac origin. Isolated, short stenoses of the iliac arteries can be opened by stenting, with an expected 80% five year patency rate. Aortoiliac bypass may provide slightly higher long term patency, but subjects the patient to a major operation and associated morbidity. Even though the left iliac narrowing in this case was not critical, it was necessary to stent both iliac orifices simultaneously because of possible impingement of the adjacent lumen by the deployment of only one stent. This was also the reason for the simultaneous expansion of the stents. The balloon mounted stents are available pre-mounted, or can be crimped over a balloon catheter as in this case. The alternative is the self-expanding (Wall) stent.
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