Long-Term Results of Stenting of the Aortic Bifurcation

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• 作者：Nicolas Abello¹ ; ² ; Benjamin Kretz¹ ; Jean Picquet³ ; Pierre-Edouard Magnan⁴ ; Reda Hassen-Khodja⁵ ; Jacques Chevalier⁶ ; Eugenio Rosset⁷ ; Patrick Feugier⁸ ; Maryse Fleury⁹ ; Eric Steinmetz¹ ; ^{eric.steinmetz@chu-dijon.fr} ; l'Association Universitaire de Recherche en Chirurgie Vasculaire (AURC)
• 刊名：Annals of Vascular Surgery
• 出版年：2012
• 出版时间：May, 2012
• 年：2012
• 卷：26
• 期：4
• 页码：521-526
• 全文大小：307 K

文摘

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Background

To evaluate the long-term results in a multicentric continuous series of narrowing lesions of the aortic bifurcation treated with a kissing stent.

Methods

From January, 1st 1999 to the December, 31st 2001, all of the patients (n = 80) presenting with stenosis of the aortic bifurcation (n = 15) and/or the 2 common iliac arteries (n = 65), treated with a kissing stent, in 8 teaching hospitals were collected retrospectively. The risk factors were smoking (91 % ), dyslipidemia (60 % ), arterial hypertension (42 % ) and diabetes (27 % ). In 84 % of cases, the indication for treatment was claudication. The lesions were stenotic < 70 % (n = 76) and/or thrombotic (n = 18). The associated lesions were external iliac stenoses (n = 21), common femoral stenoses (n = 19), femoro-popliteal stenoses (n = 42), arteriopathy in the leg (n = 35). Follow-up was clinical examination and Doppler US scan.

Results

The success rate of the technique was 89 % . There were 4 cases (5.3 % ) of residual stenosis and 4 cases (5.3 % ) of dissection. The length of the lesions treated in the aorta and the iliac arteries was respectively 17.1 ¡À 7 and 17.3 ¡À 9 mm. The stents were all placed as kissing stents, and had a mean diameter and a mean length of 13.75 mm and 56 mm in the aorta and 9 mm and 48 mm in the iliac arteries, respectively. At 5 years, 19 patients had required repeat angioplasty in the treated area, and 13 had undergone open surgery. Primary and assisted primary patency at 5 years were 64.5 % and 81.8 % , respectively.

Conclusion

Long-term follow-up of endovascular treatment with kissing stents for stenosis of the aortic bifurcation shows that this technique gives good results, though it does not justify doing away with classical revascularisation surgery, in a population with major cardiovascular risk factors.