Division of Angiography, Interventional Radiology, and Special Procedures, Department of Radiology/Box 800170, University of Virginia Health System, Jefferson Park Ave, Charlottesville, VA 22908, USA.
J Vasc Interv Radiol. 2010 Jul;21(7):995-1003. doi: 10.1016/j.jvir.2010.02.032. Epub 2010 Jun 11.
To review the outcomes with the use of balloon-expandable covered iliac kissing stents as compared with bare metal stents in the treatment of atherosclerotic disease at the aortic bifurcation.
A review of consecutive patients from a single institution with atherosclerotic occlusive disease at the aortic bifurcation treated with balloon-expandable kissing stents was performed between January 1, 2002, and September 1, 2007. Fifty-four patients were identified and divided into two groups: those with bare metal stents and those with covered stents. Technical and clinical success (Fontaine classification), complications, and patency at follow-up were documented.
Twenty-six patients (17 men, nine women; mean age, 61 years; age range, 39-79 years) received covered stents and 28 patients (15 men, 13 women; mean age, 61 years; age range, 38-82 years) received bare metal stents. Technical success was achieved in 100% of patients in both groups. Major complications occurred in three of the 26 (11%) with covered stents (P = .66) and two of the 28 patients (7%) with bare metal stents. The median follow-up was 21 months (20 months for covered stents vs 25 months for bare metal stents; range, 1-62 months). Twenty-two of the 26 patients (85%) with covered stents had sustained improvement in clinical symptoms during the follow-up period compared with 15 of the 28 patients (54%) with bare metal stents (P = .02). Primary patency rates at 1 and 2 years were 92% and 92%, respectively, for covered stents and 78% and 62% for bare metal stents (P = .023).
The use of covered balloon-expandable kissing stents for atherosclerotic aortic bifurcation occlusive disease provides superior patency at 2 years as compared with bare metal balloon-expandable stents.
回顾使用球囊扩张覆膜髂内吻合并置管治疗主动脉分叉处粥样硬化性疾病的结果，并与裸金属支架进行比较。
对 2002 年 1 月 1 日至 2007 年 9 月 1 日期间在一家医疗机构接受球囊扩张吻合并置管治疗的主动脉分叉处粥样硬化性闭塞性疾病的连续患者进行回顾性研究。共确定了 54 名患者，分为两组：裸金属支架组和覆膜支架组。记录技术和临床成功率（Fontaine 分级）、并发症以及随访时的通畅率。
26 名患者（17 名男性，9 名女性；平均年龄 61 岁；年龄范围 39-79 岁）接受了覆膜支架治疗，28 名患者（15 名男性，13 名女性；平均年龄 61 岁；年龄范围 38-82 岁）接受了裸金属支架治疗。两组患者的技术成功率均达到 100%。覆膜支架组有 3 例（11%）和裸金属支架组有 2 例（7%）发生主要并发症（P=.66）。中位随访时间为 21 个月（覆膜支架组 20 个月，裸金属支架组 25 个月；范围 1-62 个月）。26 名接受覆膜支架治疗的患者中有 22 名（85%）在随访期间临床症状持续改善，而 28 名接受裸金属支架治疗的患者中有 15 名（54%）（P=.02）。覆膜支架组 1 年和 2 年的通畅率分别为 92%和 92%，裸金属支架组分别为 78%和 62%（P=.023）。
与裸金属球囊扩张支架相比，使用球囊扩张覆膜髂内吻合并置管治疗主动脉分叉处粥样硬化性闭塞性疾病可提供更优的 2 年通畅率。
