Primary infrarenal aortic stenting with or without iliac stenting for isolated and aortoiliac stenoses: single-centre experience with long-term follow-up
Autor: | Duncan F. Ettles, M. Ahmed, P. M. Scott, R. Lakshminarayan, V. Shrivastava, G. J. Robinson, Charles R. Tapping |
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Rok vydání: | 2011 |
Předmět: |
Male
medicine.medical_specialty Time Factors Long term follow up medicine.medical_treatment Constriction Pathologic Kaplan-Meier Estimate Renal Artery Obstruction Aortography Iliac Artery Risk Assessment Severity of Illness Index Statistics Nonparametric Cohort Studies Sex Factors Angioplasty Medicine Fluoroscopy Humans Radiology Nuclear Medicine and imaging Aorta Abdominal Endovascular treatment Vascular Patency Aged Retrospective Studies medicine.diagnostic_test business.industry Endovascular Procedures Age Factors Middle Aged medicine.disease Surgery Stenosis Single centre Iliac stenting medicine.anatomical_structure Treatment Outcome Female Stents Radiology Ankle Cardiology and Cardiovascular Medicine business Angioplasty Balloon Follow-Up Studies |
Zdroj: | Cardiovascular and interventional radiology. 36(1) |
ISSN: | 1432-086X |
Popis: | The purpose of this study was to evaluate the technical success, complications, long-term clinical outcome, and patency after primary infrarenal aortic stenting for aortic and aortoiliac stenosis. Between January 1999 and January 2006, 22 consecutive patients underwent endovascular treatment because of infrarenal aortic stenosis with and without common iliac stenosis (10 men; mean age 64 ± 14 years). Eleven (11 of 22) patients had an isolated aortic stenosis, whereas 11 of 22 had aortic stenosis that extended into the common iliac arteries (CIAs). Thirteen patients were Rutherford classification type 3, and 9 patients were type 4. Statistical analysis included paired Student t test and Kaplan-Meier life table analysis; p 0.05 was considered significant. Technical and initial clinical success was achieved in all patients. There were three (14 %) procedure-related complications, which included two access-point pseudoaneurysms and one non-flow-limiting left external iliac dissection. Patients were followed-up for a mean period of 88 months (range 60-132). Mean preprocedure ankle brachial pressure indexes (ABPI) were 0.60 ± -0.15 (right) and 0.61 ± -0.16 (left). After the procedure they were 0.86 ± -0.07 (right) and 0.90 ± -0.09 (left). The increase in ABPI was significant (p 0.05), and this continued throughout follow-up. Four (18 %) patients had recurrence of symptoms during follow-up. These occurred at 36, 48, 48, and 50 months after the original procedure. All four patients were successfully treated with repeat angioplasty procedures. There was a significant difference in primary patency between isolated aortic stenosis (100 %) and aortoiliac stenosis (60 %) (p = 0.031). Cumulative follow-up was 1920 months yielding a reintervention rate of 0.025/events/year.Primary stenting of infrarenal stenosis is safe and successful with a low reintervention rate. It should be considered as first-line treatment for patients with infrarenal aortic stenotic disease. |
Databáze: | OpenAIRE |
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