Advances in endovascular therapy have provided new options for treatment of femoropopliteal disease.
To evaluate the safety and efficacy of Viabahn庐 for the treatment of femoral-popliteal artery disease.
From 2005 until 2010, a Viabahn庐 endoprosthesis was implanted in 30 limbs of 30 patients to treat superficial femoral artery and above-knee occlusive lesions. Follow-up evaluation with ankle-brachial indices and colour flow duplex imaging were performed at 1, 3, 6, 12 months, and then, each year.
A total of 30 patients were treated, with a mean age of 69 years (range 45-82), including 87%(26) male, 57%(17) diabetic, 73%(22) hypertensive, and 87%(26) current or former smokers. Patients had chronic limb ischemia in Fontaine stages IIb 13.3%, III (46.7%), and IV (40%). The treated lesions were TASC II A 16.7%(5), B 60%(18) and C 23.3%(7). There were 25 chronic occlusions (83.3%) and 5 stenoses (16.7%). The average length of treated lesions was 69 mm (range 20-150 mm). In 2 cases, major complications (1 early thrombosis and 1 thromboembolism) required additional surgery. The mean follow-up was 16 months. The primary patency rates were 74.7%, 65.4%, and 56%at 6, 12 and 24 months. Four restenoses were successfully treated. The assisted primary patency rates were 80.7%, 75.3%, and 64.6%at 6, 12 and 24 months. Late thrombosis was observed in 7 cases (23.3%). The secondary patency rates were 84.2%, 78.9%, and 69%at 6, 12, and 24 months.
Management of femoro-popliteal arterial occlusive lesions with stent-grafts has acceptable clinical results in selected patients. However, strict monitoring is needed, and a high number of reoperations are expected to ensure proper patency.