Iliac Artery Stenting Combined with Ipsilateral Open Femoro-Popliteal Revascularization and Its Effect on Bypass Patency

Piazza, Michele; Squizzato, Francesco; Lepidi, Sandro; Menegolo, Mirko; Grego, Franco; Antonello, Michele

doi:10.1016/j.avsg.2017.04.018

Cited by 4 publications

(6 citation statements)

References 19 publications

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“…Eighteen publications were excluded after the full article was reviewed; of these, nine publications were not about CBE stents. Six publications did not present stratified outcomes (ie, the study did not distinguish outcomes using CBE stents vs other therapeutic modalities) 13,[17][18][19][20][21] and three presented outcomes of fewer than five patients treated with CBE stents. [22][23][24] A total of 15 publications (14 studies) were ultimately included in this review and underwent data extraction (Table I).…”

Section: Methodsmentioning

confidence: 99%

A systematic review of covered balloon-expandable stents for treating aortoiliac occlusive disease

Mwipatayi

Ouriel²,

Anwari

et al. 2020

Journal of Vascular Surgery

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Objective: To evaluate and compare studies reporting the outcomes of the use of covered balloon-expandable (CBE) stents for the treatment of aortoiliac occlusive disease. Methods: A systematic literature search was conducted to identify studies that investigated the use of CBE stents for the treatment of aortoiliac occlusive disease and were published between 2000 and 2019. Baseline demographic data, procedural variables, and long-term outcomes were extracted from publications for analysis. Results: A total of 15 published articles about 14 studies were included in the review. Of these, eight studies were prospective clinical trials and six studies were retrospective real-world studies. The articles included data regarding five different CBE stents, namely, the iCast/Advanta V12, Viabahn VBX, BeGraft, LifeStream, and JOSTENT. Lesion severity was higher in real-world studies, with more TransAtlantic Inter-Society Consensus Classification class D lesions and a higher percentage of occlusions. All studies showed high rates of technical success and patency over the course of 12 months. Long-term data were only available for the iCast/Advanta V12 device, which had a primary patency rate of 74.7% at 5 years. Conclusions: CBE stents are a viable treatment option for patients with complex aortoiliac lesions because of their high rates of technical success and favorable patency across all devices at 12 months. However, long-term data are only available for a single device, the iCast/Advanta V12. The results of using this device were favorable over the course of 5 years.

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Section: Methodsmentioning

confidence: 99%

A systematic review of covered balloon-expandable stents for treating aortoiliac occlusive disease

Mwipatayi

Ouriel²,

Anwari

et al. 2020

Journal of Vascular Surgery

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“…1 In particular, the use of covered stents (CSs) has shown improved midterm patency rates in the treatment of TransAtlantic Inter-Society Consensus (TASC) class D lesions, 2,3 iliac occlusions, 4 long lesions involving both the common iliac arteries (CIAs) and the external iliac arteries (EIAs), 5 and multilevel peripheral arterial disease. 6 For TASC class C and D bilateral obstructive lesions involving the aortic bifurcation, the traditional endovascular approach has been the kissing stent technique. The kissing stent technique consists of the simultaneous deployment of two parallel stents from the distal aorta to both CIAs and has demonstrated high technical success, low early complication, and satisfactory midterm patency rates.…”

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confidence: 99%

Covered versus bare metal kissing stents for reconstruction of the aortic bifurcation in the ILIACS registry

Squizzato

Piazza

Pulli

et al. 2021

Journal of Vascular Surgery

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“…Piazza et al retrospectively assessed the patency of hybrid procedures in 75 patients with femoropopliteal bypass and stented TASC-II C, D iliac lesions. 13 The 42-month primary patency of the iliofemoral segment was 65.2% (95% CI: 53–86%). This finding was primarily related to femoropopliteal bypass occlusion (primary patency, 69.5%), rather than iliac stent loss of patency (primary patency, 94.6%).…”

Section: Discussionmentioning

confidence: 95%

“…In our study, we selected to perform only endovascular interventions on the iliac inflow due to lower morbidity. 1,2,12,13…”

Section: Discussionmentioning

confidence: 99%

“…In our study, we selected to perform only endovascular interventions on the iliac inflow due to lower morbidity. 1,2,12,13 The reported 24-month primary patency of hybrid procedures in iliac and femoropopliteal arteries ranges from 72.2% to 93.3%. 3,[14][15][16] When assessing the patency of the femoropopliteal bypass, the type of conduit and the level of distal anastomosis are important.…”

Section: Discussionmentioning

confidence: 99%

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The effect of the stented iliac lesions TASC-II C, D on the femoropopliteal bypass patency: Propensity score-matched observational study

et al. 2021

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Introduction Concurrent stenting of complex iliac lesions during infrainguinal bypasses can increase the complexity of a case and impact outcomes. Objective Our aim was to evaluate the effect of inflow stenting of TASC-II C, D iliac lesions on femoropopliteal bypass patency. Methods A retrospective observational cohort study of patients who underwent femoropopliteal bypass with TASC-II C, D iliac artery stenting (hybrid group) or without inflow lesions (non-hybrid group) was conducted. After propensity score matching, 120 patients were included in the non-hybrid group and 60 patients in the hybrid one. The median follow-up was 432 (193; 1313) days in the hybrid group and 472 (196; 1376) days in the non-hybrid group ( p = 0.94). Results No significant differences were found between the groups in 30-day morbidity and serious adverse events. At 3 years, primary and secondary bypass patency for the hybrid group and non-hybrid group were 62.2% versus 59.9% ( p = 0.36) and 63.7% versus 64.3% ( p = 0.077), respectively. The primary patency of the iliac stents in patients of the hybrid group was 95% at 3 years. The estimated hazard ratio for primary patency for hybrid versus non-hybrid was 0.77, with 90% CI: 0.50–1.21; the noninferiority upper bound being 1.31, which corresponds to a 10% additive noninferiority margin for probabilities. The 3 years of freedom from amputation in patients with chronic limb-threatening ischemia was 94.1% and 75.0% in the hybrid and non-hybrid groups, respectively ( p = 0.09). Conclusion The outcomes of the femoropopliteal bypass in hybrid surgery supplemented with stenting of TASC-II C, D iliac lesions was similar to femoropopliteal bypass with intact inflow arteries.

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Iliac Artery Stenting Combined with Ipsilateral Open Femoro-Popliteal Revascularization and Its Effect on Bypass Patency

Abstract: Concurrent IS-FPB has acceptable early and long-term results. Even if further studies are needed, the use of a CS for the iliac obstruction seem to provide better outcomes in the hybrid treatment of these cases of multilevel disease.

Cited by 4 publications

References 19 publications

A systematic review of covered balloon-expandable stents for treating aortoiliac occlusive disease

A systematic review of covered balloon-expandable stents for treating aortoiliac occlusive disease

Covered versus bare metal kissing stents for reconstruction of the aortic bifurcation in the ILIACS registry

The effect of the stented iliac lesions TASC-II C, D on the femoropopliteal bypass patency: Propensity score-matched observational study

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