The Results of Self-Expandable Kissing Stents in Aortic Bifurcation

Abstract

Purpose:Kissing stent reconstruction is a widely used technique for the management of aortoiliac occlusive disease involving the aortic bifurcation or proximal common iliac arteries. The purpose of this study was to evaluate the results of self-expandable kissing stents in the aortic bifurcation.Materials and Methods:We reviewed medical records of the patients treated with a kissing stent retrospectively from January 2007 to December 2012. The primary and secondary patencies were determined with Kaplan-Meier analysis, and Cox regression was used to determine the factors associated with patency.Results:A total of 21 patients were included, and all were male (median age 53±15 years, range 48–78 years). Major symptoms were claudication (n=16, 61.9%), rest pain (n=5, 23.8%) and gangrene (n=5, 23.8%). Tans-Atlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC) II classification was A 2 (9.5%), B 5 (23.8%), C 7 (33.3%) and D 8 (38%). The mean follow-up was 40.7 months. Major complication occurred in only one case which consisted of distal limb ischemia by emboli. Six patients developed symptomatic restenosis or occlusion. There was no major amputation, but minor amputation occurred in 3 patients. There were 2 mortalities not associated with the procedure (lung cancer and intracranial hemorrhage). Primary patency was 89.6% at 1 year, 74.7% at 3 years and 64.0% at 5 years. Secondary patency was 94.1% at 1 year, 88.2% at 3 years and 68.6% at 5 years. No risk factors for restenosis or occlusion were identified.Conclusion:Self-expandable kissing stents can be used successfully with comparable patency for endovascular treatment of symptomatic atherosclerotic occlusive lesions in the aortic bifurcation area.

Stent Protrusion >20 mm Into the Aorta: A New Predictor for Restenosis After Kissing Stent Reconstruction of the Aortoiliac Bifurcation

“…Published mid- to long-term primary patency rates for kissing stent reconstruction of the aortic bifurcation have ranged from 87% to 97%, 65% to 96%, and 64% to 82% at 12, 24, and 60 months, respectively, while secondary patency rates were 94% to 100%, 91% to 100%, and 69% to 91%. 7,14–18 Our 77% and 99% primary and secondary 60-month patency rates are in keeping with these experiences.…”

Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease

“…12 The updated search query identified 22 articles. 1–6,8–10,13–25 Authors of 19 articles with contact information were invited by electronic mail to join the consortium, and a communication log was kept to overview all responses. If the authors did not respond to the request, a second letter was sent; if this remained unanswered the study was excluded.…”

Reconstruction of infrarenal abdominal aortic occlusion using the Culotte stenting technique: a case report

“…наблюдения [17,18]. В исследовании Moon JY, et al при имплантации самораскрывающих голометаллических стентов по методу kissing-stent technique показатели первичной проходимости стентов составили 89,6% через 12 мес., 74,7% через 3 года, 64,0% через 5 лет [19]. Наиболее эффективной данная техника является при использовании баллон-расширяемых стент-графтов: 5-летние результаты многоцентрового исследования COBEST (the COvered versus Balloon Expandable Stent Trial) показали, что стентграфты имели значительно более высокую проходимость, чем голометаллические стенты через 18, 24, 48 и 60 мес.…”