Haulon Stéphan, Mounier-Véhier Claire, Gaxotte Virginia, Koussa Mohamad, Lions Christophe, Haouari Ben Ahmed, Beregi Jean-Paul
Department of Vascular Surgery, Hôpital Cardiologique, CHRU de Lille, 59038 Lille Cedex, France.
J Endovasc Ther. 2002 Jun;9(3):363-8. doi: 10.1177/152660280200900317.
To evaluate the long-term results using the kissing stents technique for treatment of occlusive disease involving the aortoiliac bifurcation.
One hundred six patients (97 men; mean age 52.5 +/- 10.2 years, range 33-78) were treated with the kissing stents technique for bilateral aortoiliac stenosis (55, 51.9%), unilateral occlusion of the common iliac artery (CIA) with contralateral stenosis (47, 44.3%), and bilateral CIA occlusion (4, 3.8%). Clinical examination and duplex scans were performed prior to discharge and at 1, 6, and 12 months, followed by yearly examinations thereafter.
Bilateral stent implantation was successful in all patients. No major procedure-related complications were observed. Self-expanding stents were deployed in 62 (58.5%) patients and balloon-expandable devices in 44 (41.5%). Fifteen (7.1%) hematomas were observed at the 212 access sites. Mean follow-up was 30.1 +/- 11.1 months (range 12-137). Duplex imaging diagnosed significant (>50%) restenosis in 15 (14.8%) of 101 patients and reocclusion in 4 (4%); 17 (89.5%) of these patients had recurrent symptoms and all were retreated (endovascular procedure in 18 and an aortobifemoral bypass in 1). Primary and secondary cumulative patency rates at 36 months were 79.4% and 97.7%, respectively. Balloon-expandable stents had a nonsignificantly higher patency rate compared to self-expanding stents.
Based on our experience, aortoiliac endovascular reconstruction with the kissing stents technique is a safe and effective procedure, representing an alternative to conventional surgery in selected patients.
评估采用吻合支架技术治疗累及主-髂动脉分叉处闭塞性疾病的长期疗效。
106例患者（97例男性；平均年龄52.5±10.2岁，范围33 - 78岁）接受了吻合支架技术治疗双侧主-髂动脉狭窄（55例，51.9%）、单侧髂总动脉（CIA）闭塞伴对侧狭窄（47例，44.3%）以及双侧CIA闭塞（4例，3.8%）。出院前、出院后1个月、6个月和12个月进行临床检查和双功扫描，此后每年检查一次。
所有患者双侧支架植入均成功。未观察到与手术相关的重大并发症。62例（58.5%）患者使用了自膨式支架，44例（41.5%）患者使用了球囊扩张式支架。在212个穿刺部位观察到15例（7.1%）血肿。平均随访时间为30.1±11.1个月（范围12 - 137个月）。双功成像诊断101例患者中有15例（14.8%）出现显著（>50%）再狭窄，4例（4%）出现再闭塞；这些患者中有17例（89.5%）出现复发症状，均接受了再次治疗（18例接受血管内介入治疗，1例接受主动脉-双股动脉搭桥术）。36个月时的初级和次级累积通畅率分别为79.4%和97.7%。球囊扩张式支架的通畅率略高于自膨式支架，但差异无统计学意义。
根据我们的经验，采用吻合支架技术进行主-髂动脉血管内重建是一种安全有效的手术方法，是特定患者传统手术的替代方案。
