Endovascular intervention of aortoiliac occlusive disease in high‐risk patients using the kissing stents technique: Long‐term results

Abstract

Endovascular intervention deploying a kissing stents (KS) technique has been used as an alternative to surgical intervention in treating symptomatic aortoiliac occlusive disease. However, the long-term results on high-risk patients are unknown. We retrospectively analyzed data on high-risk patients who underwent endovascular intervention using the KS technique at our institution. Fifty high-risk patients aged 62 +/- 6.4 years with severe aortoiliac stenosis underwent stent-supported angioplasty using the KS technique. Thirty percent of the patients had total occlusion of the distal aorta and/or the iliac arteries. Twelve patients received thrombolytics prior to stenting. The procedure was successful in all 50 patients. There was a 4% acute complication rate (distal embolization). However, there were no vascular complications, myocardial infarction, or perioperative death. Primary patency during follow-up of 20 +/- 12.3 months was 92%, while secondary patency rate was 100%. Amputation-free survival was 100%. Ninety-two percent remained free of lifestyle-limiting claudication.

Aortoiliac Kissing Stents:Long-term Results and Analysis of Risk Factors Affecting Patency

“…Complications oc- curred in 0% to 16%, including hematoma, pseudoaneurysm, arteriovenous fistula, distal embolism, and aortoiliac dissection. [6][7][8][9][10][11][12][13][14] In our series, the technical success (100%), complication rate (12%), and the type of complications were comparable to these studies. However, in our study, the follow-up period was longer, and all 3 patency rates are presented up to 5 years.…”

Outcomes of the single-stent versus kissing-stents technique in asymmetric complex aortoiliac bifurcation lesions

“…Therefore, the kissing-stents technique with simultaneous bilateral implantation of stents has been used for the endovascular treatment of the aortoiliac bifurcation. Previous studies demonstrated high technical success and favorable 4,[7][8][9][10][11] whereas other studies reported relatively poorer outcomes, with patency rates of 45% to 65%. [12][13][14][15] The inconsistency in immediate and later outcomes among previous studies may reflect heterogeneity in study populations, lesion characteristics, and procedural techniques.…”

Current Treatment of Peripheral Arterial Disease

“…The "kissing stent" technique with BE stents is recommended when there is minimal disease affecting the terminal aorta and the ostia of both common iliac arteries are being treated. Excellent procedural outcomes (100% success without any major adverse events) and long-term patency (primary patency 92% and secondary patency 100% at 20 months) have been reported with this approach, even in a cohort of high-risk patients with disease affecting the terminal aorta and aortoiliac bifurcation (97).…”