Pulmonary artery stenting in a patient with Takayasu's arteritis using a novel balloon-expandable covered stent

Abstract

Patients with Takayasu's arteritis have pulmonary artery involvement more commonly than previously appreciated. The majority of these lesions are in segmental or sub-segmental arteries, but there are some patients who have severe stenosis of the main pulmonary arteries. Interventional treatment of these patients is technically feasible, but there are only limited case reports describing such intervention. Balloon angioplasty and stenting in these lesions often require high pressure inflations to achieve adequate results and thus has increased risk due to the possibility of pulmonary artery rupture. The recently approved Viabahn BX balloon-expandable covered stent may be an optimal device for main pulmonary artery stenosis as it is relatively low profile, can be over-expanded to large vessel diameter without compromise or disruption of the polytetrafluoroethylene covering and virtually eliminates the risk of catastrophic pulmonary artery rupture. We report here the first known use of this novel stent for treatment of severe pulmonary artery stenosis.

Keywords: Cardiovascular; Takayasu’s arteritis; pulmonary hypertension; stent.

Figure 1.

CT angiogram of right pulmonary artery.

Figure 2.

Selective right pulmonary artery baseline angiogram.

Figure 3.

Final angiogram. Right pulmonary artery after Viabahn BX stent.