Long-term Follow-up of Endoluminal Grafting for Aneurysmal and Occlusive Disease in the Superficial Femoral Artery

Abstract

Purpose: To examine the long-term outcome of patients treated with endoluminal grafts (ELGs) for aneurysmal and occlusive disease in the femoropopliteal (FP) segment. Methods: ELGs of radially expandable polytetrafluoroethylene with terminal Palmaz stents were used to form intimal conduits to revascularize lengthy occlusive disease and exclude aneurysms in the FP segment. Patient records were reviewed retrospectively for outcome. Results: Fifty-five (98%) of 56 ELGs were placed successfully in 51 patients treated from August 1993 to February 1996. Over a mean 36-month follow-up, 28 (50%) ELGs occluded. Half of these failures reflected early technical difficulties. There were 11 (20%) stent stenoses, 6 in the proximal stent and 5 in the distal device. The majority of the graft failures were treated with endovascular techniques; however, FP bypass was required in 7 (25%) patients, while 2 (7%) were not treated. Life-table analysis demonstrated 46% primary and 68% secondary patency rates at 24 months. Among demographic and procedural variables, only previous dilation or stent procedures in the target artery was associated with failure (p < 0.0001). Conclusions: The prototype ELG used in this series demonstrated durability similar to conventional surgical therapy utilizing synthetic material. Endoluminal grafting of FP lesions may be a more durable alternative to classical bypass once devices and techniques are refined.

Treatment of Catheter-Induced Iliac Artery Injuries with Self-Expanding Endografts

“…The safety and efficacy of endovascular stent-grafts have been demonstrated in a variety of peripheral arterial pathologies, including trauma and aneurysmal disease. 6,7,[11][12][13][14] In our study, primary technical success was achieved in all 20 consecutive cases, confirming that implantation of covered stents is highly effective in repairing traumatic arterial lesions and re-establishing the vascular integrity of the injured vessel. Angiography and CT scans have clearly demonstrated that the initial effect was maintained over a median 21month follow-up.…”

Results With Viabahn-Assisted Subintimal Recanalization for TASC C and TASC D Superficial Femoral Artery Occlusive Disease

“…Thus, covered stents may have an advantage over bare metal stents, and some authors have made such an observation. [31][32][33] Although reported results with Hemobahn and Viabahn stent grafts have been encouraging, [31][32][33][34][35][36][37][38][39][40][41][42][43] there have been no reports of direct comparison to outcomes with uncovered stents. This information void is the basis of the VIBRANT trial that will compare results with uncovered metal to Viabahn stents for TASC C and D disease in the SFA.…”

Balloon Dilation and Stent Implantation for Treatment of Femoropopliteal Arterial Disease: Meta-Analysis

“…At present, new endovascular stent-graft systems are being developed (8,11,12). To enable comparison of the results of a new therapy with established therapies, data on benefits and costs of the established procedures must be available.…”