Transbrachial endovascular exclusion of an axillary artery pseudoaneurysm with PTFE-covered stents

PURPOSE: Endovascular exclusion of arterial injuries associated with arteriovenous fistulas and pseudoaneurysms has only recently been described using various stent-graft prostheses. This report details a transbrachial technique used to exclude an axillary artery pseudoaneurysm developing at the axillary anastomosis of an axillofemoral graft. METHODS AND RESULTS: Thin-walled polytetrafluoroethylene was expanded with an angioplasty balloon catheter and used to cover standard Palmaz stents. Two covered stents were delivered under fluoroscopic guidance via open brachial artery access to the site, resulting in complete exclusion of the pseudoaneurysm. Follow-up duplex scanning confirmed aneurysm exclusion 3 months postprocedure. CONCLUSIONS: This technique can be applied in arteries of different sizes and lengths, using currently available materials. However, the long-term behavior of these devices in the arterial tree must be determined before their widespread use can be recommended for most indications.