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Both Common Iliac Artey Intervention using Simultaneous Kissing Stent Technique
- Operator: Seung-Whan, Lee, MD
Clinical Information

- Relevant clinical history and physical exam:
The patients was a 66-year old man with claudication of both legs for 2 years. The pulsation of both dorsalis pedis could be palpable, weakly. His coronary risk factors were hypertension, diabetes and smoking. He was diagnosed with peripheral artery disease (both common iliac arteries) by peripheral CT angiography at another hospital. He visited our hospital for proper management. He received percutaneous coronary intervention about 1 month ago.

- Relevant test results prior to catheterization:
CT angiography showed significant stenosis of both common iliac arteries (CIA). Segmental limb pressure with doppler revealed severely decreased both ankle-brachial indices and pressure drop was noted at both aorto-iliac segments.

- Relevant angiography findings:
The diffuse, significant stenosis of both common iliac arteries were revealed (Figure 1).

Interventional Management

- Procedural step:
Two 7 Fr sized femoral sheaths were inserted into the left femoral artery. Two Amplatz Super Stiff 0.035 inch wire were inserted into both femoral arteries to descending aorta, cautiously. Pre-balloon with RIDER 5.0 * 40mm sized balloon was performed at Lt.CIA.(Figure 2) And then, simultaneous kissing stenting with Express vascular LD 8 * 57 mm upto 8.33 (10 atm) in Rt. CIA and Express vascular LD 7 * 57mm upto 7.33 (10 atm) in Lt. CIA was performed.(Figure 3) Post-stenting balloon with stent balloon upto 8.46 (12 atm) in Rt.CIA and upto 7.46 (12 atm) was perfomed sequentially.(Figure 4) Final angiogram showed well-positioned stent in both CIAs.(Figure 5)

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