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Midterm Outcomes of Kissing Covered Self-Expanding Stents for Reconstruction of Complex Aortoiliac Occlusive Disease.
Shen, Chen-Yang; Qu, Cheng-Jia; Zhang, Yong-Bao; Fang, Jie; Teng, Le-Qun; Li, Jia-Liang.
Afiliación
  • Shen CY; Vascular Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China. Electronic address: scy@fuwaihospital.org.
  • Qu CJ; Vascular Surgery Center, Ji Shuitan Hospital, Beijing, PR China.
  • Zhang YB; Vascular Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China.
  • Fang J; Vascular Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China.
  • Teng LQ; Vascular Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China.
  • Li JL; Vascular Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China.
Ann Vasc Surg ; 94: 239-245, 2023 Aug.
Article en En | MEDLINE | ID: mdl-36870565
BACKGROUND: We sought to investigate the midterm results of kissing self-expanding covered stents (SECSs) for the reconstruction of aortic bifurcation in complex aortoiliac occlusive disease. METHODS: Data of consecutive patients who had undergone endovascular treatment for aortoiliac occlusive disease were screened. Only patients with TransAtlantic Inter-Society Consensus (TASC) class C and D lesions treated by bilateral iliac kissing stents (KSs) were included. Midterm primary patency, risk factors, and limb salvage rates were analyzed. Follow-up results were analyzed using the Kaplan-Meier curves. Cox proportional hazards models were used to identify the predictors of primary patency. RESULTS: A total of 48 patients (95.8% men; mean age, 65.3 ± 10.2 years) were treated with kissing SECSs. Of them, 17 patients had TASC-II class C lesions and 31 had class D lesions. There were 38 total occlusive lesions, with a mean occlusive lesion length of 108.2 ± 57.3 mm. The overall mean lesion length was 140.3 ± 60.5 mm, and the mean length of implanted stents in the aortoiliac arteries was 141.9 ± 59.9 mm. The mean diameter of the deployed SECSs was 7.8 ± 0.5 mm. The mean follow-up time was 36.5 ± 15.8 months, and the follow-up rate was 95.8%. At 36 months, the overall primary patency, assisted primary patency, secondary patency, and limb salvage rates were 92.2%, 95.7%, 97.8%, and 100%, respectively. Univariate Cox regression analysis revealed that stent diameter ≤7 mm (hazard ratio [HR]: 9.53; 95% confidence interval [CI] 1.56-57.94, P = 0.014) and severe calcification (HR: 12.66; 95% CI 2.04-78.45, P = 0.006) were significantly associated with restenosis. Multivariate analysis showed severe calcification to be the only significant determinant of restenosis (HR: 12.66; 95% CI 2.04-78.45, P = 0.006). CONCLUSIONS: Kissing SECSs provide good midterm results for the treatment of aortoiliac occlusive disease. A stent diameter >7 mm is a potent protective factor against restenosis. Because severe calcification appears to be the only significant determinant of restenosis, patients with severe calcification require close follow-up.
Asunto(s)

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Enfermedades de la Aorta / Arteriopatías Oclusivas / Calcinosis / Aterosclerosis / Síndrome de Leriche Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Vasc Surg Asunto de la revista: ANGIOLOGIA Año: 2023 Tipo del documento: Article

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Enfermedades de la Aorta / Arteriopatías Oclusivas / Calcinosis / Aterosclerosis / Síndrome de Leriche Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Vasc Surg Asunto de la revista: ANGIOLOGIA Año: 2023 Tipo del documento: Article