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Outcomes of Total Aortoiliac Revascularization for TASC-II C&D Lesion with Kissing Self-Expanding Covered Stents.

OBJECTIVE The endovascular approach has been widely used for aortoiliac occlusive disease (AIOD), especially for aortic bifurcation and iliac artery Trans-Atlantic Inter-Society Consensus-II (TASC-II) A and B lesions. However, the… Click to show full abstract

OBJECTIVE The endovascular approach has been widely used for aortoiliac occlusive disease (AIOD), especially for aortic bifurcation and iliac artery Trans-Atlantic Inter-Society Consensus-II (TASC-II) A and B lesions. However, the outcomes of self-expanding covered stents (SECSs) for extensive aortoiliac lesion remain unclear. This study aimed to assess the short-term patency of kissing covered stents for the revascularization of aortoiliac TASC-II C and D diseases. MATERIALS AND METHODS Thirty-three patients with TASC-II C and D lesions of AIOD were treated with kissing covered stents. All patients were reviewed under a standard institutional review board protocol. Demographic variables, lesion location and characteristics, stenting configuration, and patency were analyzed. RESULTS Thirty-one male and 2 female patients with a mean age of 65.1 ± 10.7 years underwent aortoiliac bifurcation reconstruction with kissing SECSs. Eight patients had TASC-II C lesions, 25 had TASC-II D lesions. Among them, 8 patients had total infrarenal aortoiliac occlusion, of which 5 had juxtarenal aortoiliac lesions. The mean lesion length was 11.6 ± 2.1 cm. Mean diameters of aorta and CIA were 18.3 ± 2.1 and 10.7 ± 1.5 mm, respectively. Among them, the abutting stent configuration was used in 11 patients with short or focal ostial lesions, whereas the crossing stent configuration was used in 22 patients with longer lesions extending into the distal aorta. The mean follow-up was 24.5 ± 7.8 months, the follow-up rate was 93.9% (31/33), and 29 patients had follow-up longer than 12 months. Primary patency rate at 12 months was 96.5%, and secondary patency rate was 100%. CONCLUSIONS The use of kissing SECSs for the revascularization of extensive AIOD is safe and effective. The short-term primary patency rates of endovascular treatment of TASC-II C and D lesions were favorable.

Keywords: patency; tasc; covered stents; tasc lesions; lesion; revascularization

Journal Title: Annals of vascular surgery
Year Published: 2020

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