Use of the Outback re-entry device for occluded abdominal aortic aneurysms with bilateral common iliac artery aneurysms

Background: Extensive juxtarenal aortoiliac occlusion (JRO) is difficult to treat and has severe outcomes. However, recent treatments have involved endovascular approaches. We encountered a rare case of successful occlusion penetration using the Outback Elite Re-entry Catheter (Cordis, Miami, FL, USA). Case presentation: A 75-year-old man was referred to our department for treatment of an enlarged aneurysm. The patient presented with intermittent claudication and underwent computed tomography, which revealed thoracic aortic, abdominal aortic (AAA), bilateral common iliac artery (CIAA), and right external iliac artery (EIAA) aneurysms of 51.8, 47.4, 71.5/31.9 (right/left), and 26.3 mm in diameter, respectively. The AAA, bilateral CIAA, and right EIAA were extensively occluded and treated with a re-entry device (outback® Elite Re-entry Catheter). The patient's symptoms improved significantly, and he was discharged with no serious complications. Conclusion: The Outback Elite Re-entry Catheter may be a promising endovascular treatment option for patients with extensive JRO

Study protocol for a prospective, multicentre, phase II trial on endoscopic treatment using two fully covered self-expandable metallic stents for benign strictures after hepaticojejunostomy

Introduction The current endoscopic treatment for postoperative benign hepaticojejunostomy anastomotic stricture (HJAS) has a high technical success rate and is highly effective in the short term. However, long-term results have shown a high rate of stenosis recurrence, which indicates an insufficient response to treatment. Three prospective studies on fully covered self-expandable metallic stent (FC-SEMS) treatment for benign HJAS used the stenosis resolution rate as the primary endpoint, and no study has yet used the long-term non-stenosis rate (at 12 months) as the primary endpoint.Methods and analysis We launched the ‘saddle-cross study’, which will be conducted as a multicentre, prospective intervention of endoscopic treatment using two modified FC-SEMSs (BONASTENT️ M-Intraductal) that have been improved for benign stenosis in patients with benign HJAS, with the long-term non-restenosis rate (at 12 months) as the primary endpoint. This study aims to evaluate the long-term non-restenosis rate (at 12 months) and safety of the saddle-cross technique for benign HJAS. We plan to enrol 50 participants.Ethics and dissemination This study has been approved by the Certified Review Board of the National Cancer Center, Japan (CRB3180009). The results will be reported at various conferences and published in international peer-reviewed journals