Fate of Asymptomatic Limb after Kissing Stents in Aortoiliac Occlusive Disease

Abstract

Purpose Kissing stent angioplasty is an established endovascular treatment strategy for stenosis at the aortic bifurcation but not without its detractors. This study aimed to analyze the outcomes of kissing stents with regard to stent occlusion and complications in which an asymptomatic limb was treated. Methods Materials and A total of 106 patients undergoing aortic bifurcation intervention from January 2015 to November 2020 were retrospectively reviewed. Only patients with at least one common iliac artery (CIA) ostium and undergoing bilateral CIA intervention were included in the study.Results: Patients were followed up for a median period of 26 months (interquartile range, 21-51 months). The TransAtlantic InterSociety Consensus (TASC)-II classification of lesions was as follows: A, 49%; B, 41%; C, 6%; and D, 5%. The treatment indication was limited to one side in 53% of patients. Technical and procedural success rates were 99% and 90%, respectively. Ischemic events in an asymptomatic limb occurred in 6% of cases, 3% due to late stent thrombosis >30 days, and 3% due to progression of downstream infrainguinal disease. Primary and secondary patency rates at 1, 3, and 5 years were 98%, 87%, and 85%, and 99%, 94%, and 94%, respectively. Periprocedural mortality developed in two patients with no amputation. Conclusion Kissing stent deployment is a safe and effective strategy for the treatment of aortoiliac bifurcation disease. Unfavorable outcomes due to stenting in the asymptomatic iliac artery are very rare. Long-term surveillance is necessary due to the risk of late thrombosis or downstream disease progression.

Influence of Combined Antioxidant Therapy on Results of Endovascular Treatment of Patients with Peripheral Arterial Disease

“…Чрескожные вмешательства обеспечивают более быстрое восстановление пациента и меньший срок пребывания в стационаре. Однако развитие рестеноза зоны реконструкции приводит к необходимости выполнения повторных операций при увеличении риска потери конечности [2][3][4]. В предыдущих наших исследованиях было показано, что маркеры системы апоптоза и пролиферации клеток являются непосредственными участниками развития рестеноза зоны реконструкции после различных видов оперативных вмешательств.…”

The Effectiveness of Ipsilateral Stenting VS Kissing Stenting in the Treatment of Unilateral Common Iliac Artery Ostial Lesion

“…However, its use is limited by initial residual stenosis, late restenosis, and a high rate of distal embolization (7,8) . Stents are frequently utilized, especially in lesions involving the distal aorta or the origin of the CIA (9) .The concept of the kissing technique arose due to concerns about the risks of plaque shift and distal embolization to the contralateral iliac artery (10) . Unilateral ostial CIA disease has been treated using a single stent deployed only on the affected side, and it has been concluded that the technique is safe and demonstrated comparable mid-term outcomes to those achieved with kissing stents (3) , that need additional devices, bilateral femoral artery access, and the potential loss of future contralateral access options in the endovascular treatment of distant lesions.…”

Incidence and Risk Factors of Iliac Artery Rupture during Aortoiliac Stenting

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2024) 40:5 widely used for steno-occlusive abdominal aorta and iliac artery disease [1][2][3]. However, there are still disadvantages because iliac artery rupture is one of the most fatal complications [4,5].

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