Picquet J, Blin V, Bouyé P, Perdreau G, Thouveny F, Enon B, L'Hoste P
Service de Chirurgie Cardiovasculaire et Thoracique, CHU, 4 rue Larrey, 49933 Angers Cedex 09.
J Mal Vasc. 2005 Jul;30(3):163-70. doi: 10.1016/s0398-0499(05)83833-8.
To evaluate short and medium-term results of endovascular repair of the aortoiliac bifurcation for occlusive disease by the kissing stent technique.
Twenty patients were included in this retrospective study between May 1999 and November 2002 (13 men, mean age 58 years, range 42-86). Fifteen were treated for bilateral common iliac artery stenosis (75%), four for unilateral common iliac artery occlusion with or without controlateral stenosis (20%), and one for bilateral common iliac artery occlusion (5%). Each patient had a clinical examination and dupplex-scan prior to discharge, at three months, twelve months then yearly.
All procedures were successful. Forty balloon expandable stents were deployed in the kissing position (mean length and diameter, 45 mm and 9 mm). Nine other stents were also deployed either in the abdominal aorta (one patient) either in the lower portion of the common iliac artery. Intra-operative complications were represented by one hematoma of the groin region treated surgically, one emboli of the femoral bifurcation treated by Forgarty balloon embolectomy, three dissections of the common iliac arteries treated by stenting, and one internal iliac artery occlusion not treated. Mean follow-up was 21 months (range 3-36). Three significant restenoses (>50%) were diagnosed during this period and one patient had an additional transluminal procedure. No intra-stent occlusion was found. Primary and secondary cumulative patencies at 12 and 36 months were respectively 94.7%, 84,4% and 100%, 89%.
We confirm the feasibility, and the reliability of endovascular aorto-iliac kissing stent reconstruction in occlusive disease for selected patients.
通过吻合支架技术评估主髂动脉分叉闭塞性疾病血管腔内修复的短期和中期结果。
本回顾性研究纳入了1999年5月至2002年11月期间的20例患者（13例男性，平均年龄58岁，范围42 - 86岁）。15例患者接受双侧髂总动脉狭窄治疗（75%），4例患者接受单侧髂总动脉闭塞伴或不伴对侧狭窄治疗（20%），1例患者接受双侧髂总动脉闭塞治疗（5%）。每位患者在出院前、术后3个月、12个月及之后每年进行临床检查和双功超声扫描。
所有手术均成功。40枚球囊扩张支架以吻合位置置入（平均长度和直径分别为45 mm和9 mm）。另外9枚支架分别置入腹主动脉（1例患者）或髂总动脉下段。术中并发症包括1例腹股沟区血肿经手术治疗，1例股动脉分叉处栓子经Fogarty球囊取栓术治疗，3例髂总动脉夹层经支架置入治疗，1例髂内动脉闭塞未治疗。平均随访时间为21个月（范围3 - 36个月）。在此期间诊断出3例严重再狭窄（>50%），1例患者接受了额外的腔内治疗。未发现支架内闭塞。12个月和36个月时的原发性和继发性累积通畅率分别为94.7%、84.4%和100%、89%。
我们证实了血管腔内主髂动脉吻合支架重建术在特定患者闭塞性疾病中的可行性和可靠性。
