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  • Title: Primary stenting for aortic lesions: from single stenoses to total aortoiliac occlusions.
    Author: Klonaris C, Katsargyris A, Tsekouras N, Alexandrou A, Giannopoulos A, Bastounis E.
    Journal: J Vasc Surg; 2008 Feb; 47(2):310-7. PubMed ID: 18241754.
    Abstract:
    PURPOSE: This study evaluated the feasibility, safety, and efficacy of primary stenting in atherosclerotic stenoses and occlusions of the infrarenal aorta. METHODS: Between January 2003 and December 2006, 12 patients (6 men) with a mean age of 66.3 +/- 4.1 years who had infrarenal aortic occlusive disease were treated with primary stenting (aortic stenosis, 8; chronic total aortobiiliac occlusion, 4). Reasons for referral were severe claudication in six patients (50%), ischemic rest pain in four (33.3%), and minor tissue loss in two (16.7%). Three patients (25%) had chronic renal failure and were on dialysis. Follow-up was performed in all 12 patients. RESULTS: Technical success was 91.7% because one patient had a residual stenosis >30% after stent placement and balloon postdilation owing to severe calcification of the aorta. However, clinical and immediate hemodynamic success was achieved in all 12 patients (100%). The preprocedural mean resting ankle-brachial index (ABI) values of 0.56 +/- 0.13 at the right side and 0.59 +/- 0.15 at the left were increased to 0.97 +/- 0.04 and 0.95 +/- 0.06, respectively, after treatment (P < .01). At the end of the mean follow-up of 18.3 months (range, 6-37 months), the primary clinical and hemodynamic patency was 91.7% +/- 7.98%, and the mean resting ABI values were 0.96 +/- 0.04 for the right and 0.92 +/- 0.1 for the left side (P < .01 compared with preinterventional values). None of the patients in the study underwent reintervention. An access-related groin hematoma developed in one patient, but no other major or minor complications occurred. One patient died 8 months after the procedure of chronic renal failure complications. CONCLUSION: Primary stenting is feasible, safe, and effective for the whole spectrum of aortic occlusive disease. Especially for patients with infrarenal aortic stenoses, it is recommended as the first-line treatment and should be considered as a viable alternative to surgery for total aortoiliac occlusions.
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