In Reply to: Case 0298_04 -- Z-stent-graft for an iatrogenic arteriovenous fistula posted by Editor on February 03, 1998 at 11:59:56:
Great example of an easy solution to a previously tough problem. I had a very similar case in a patient post radical prostatectomy and XRT. I have used almost every stent around at this point to fashion a stent-graft on the bench top, and have used most in patients.
The easiest and lowest profile system yet has been the Long medium Palmaz with thin Impra. This goes through an 8F sheath. The most reliable for long or curved lesions has been the Wallstent, which goes through a 10F sheath (as does the "manufactured" version the Wallgraft). I have stayed away from Z-stents because of the need for overnight sterilization, but the one I used peformed well. You guys clearly have alot more experience with the Z-stents. The only leaks I have seen with any of the devices were with aneurysms, and all but one of those was sealed at 3 months. I anxiously await the day that I can quit making these, and use an FDA approved version, but until then, I will continue to do what I and my surgeons think is best for the patients.