Shen Chenyang, Zhang Yongbao, Qu Chengjia, Fang Jie, Liu Xinnong, Teng Lequn
Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Disease, National Key Laboratory for Cardiovascular Disease, Fuwai Hospital, Vascular Surgery Center, Beijing, China.
Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Disease, National Key Laboratory for Cardiovascular Disease, Fuwai Hospital, Vascular Surgery Center, Beijing, China.
Ann Vasc Surg. 2020 Oct;68:434-441. doi: 10.1016/j.avsg.2020.04.055. Epub 2020 May 16.
The endovascular approach has been widely used for aortoiliac occlusive disease (AIOD), especially for aortic bifurcation and iliac artery Trans-Atlantic Inter-Society Consensus II (TASC-II) A and B lesions. However, the outcomes of self-expanding covered stents (SECSs) for extensive aortoiliac lesion remain unclear. This study aimed to assess the short-term patency of kissing covered stents for the revascularization of aortoiliac TASC-II C and D diseases.
Thirty-three patients with TASC-II C and D lesions of AIOD were treated with kissing covered stents. All patients were reviewed under a standard institutional review board protocol. Demographic variables, lesion location and characteristics, stenting configuration, and patency were analyzed.
Thirty-one male and 2 female patients with a mean age of 65.1 ± 10.7 years underwent aortoiliac bifurcation reconstruction with kissing SECSs. Eight patients had TASC-II C lesions, and 25 patients had TASC-II D lesions. Among them, 8 patients had total infrarenal aortoiliac occlusion, of which 5 had juxtarenal aortoiliac lesions. The mean lesion length was 11.6 ± 2.1 cm. Mean diameters of aorta and common iliac artery were 18.3 ± 2.1 and 10.7 ± 1.5 mm, respectively. Among them, the abutting stent configuration was used in 11 patients with short or focal ostial lesions, whereas the crossing stent configuration was used in 22 patients with longer lesions extending into the distal aorta. The mean follow-up was 24.5 ± 7.8 months, the follow-up rate was 93.9% (31 of 33), and 29 patients had follow-up longer than 12 months. Primary patency rate at 12 months was 96.5%, and secondary patency rate was 100%.
The use of kissing SECSs for the revascularization of extensive AIOD is safe and effective. The short-term primary patency rates of endovascular treatment of TASC-II C and D lesions were favorable.
血管内介入治疗已广泛应用于主髂动脉闭塞性疾病（AIOD），尤其是主动脉分叉和髂动脉的跨大西洋跨学会共识II（TASC-II）A 型和 B 型病变。然而，自膨式覆膜支架（SECS）治疗广泛性主髂动脉病变的疗效仍不明确。本研究旨在评估用于主髂动脉 TASC-II C 型和 D 型疾病血运重建的吻合法覆膜支架的短期通畅率。
33 例主髂动脉闭塞性疾病 TASC-II C 型和 D 型病变患者接受吻合法覆膜支架治疗。所有患者均按照标准的机构审查委员会方案进行复查。分析人口统计学变量、病变位置和特征、支架置入构型及通畅率。
31 例男性和 2 例女性患者接受了吻合法自膨式覆膜支架主髂动脉分叉重建术，平均年龄为 65.1±10.7 岁。8 例患者为 TASC-II C 型病变，25 例患者为 TASC-II D 型病变。其中，8 例患者为肾下腹主动脉髂动脉完全闭塞，其中 5 例为近肾主动脉髂动脉病变。平均病变长度为 11.6±2.1cm。主动脉和髂总动脉的平均直径分别为 18.3±2.1mm 和 10.7±1.5mm。其中，11 例短节段或局灶性开口病变患者采用对接支架构型，22 例病变较长且延伸至远端主动脉的患者采用交叉支架构型。平均随访时间为 24.5±7.8 个月，随访率为 93.9%（33 例中的 31 例），29 例患者随访时间超过 12 个月。12 个月时的原发性通畅率为 96.5%，继发性通畅率为 100%。
吻合法自膨式覆膜支架用于广泛性主髂动脉闭塞性疾病血运重建安全有效。TASC-II C 型和 D 型病变血管内治疗的短期原发性通畅率良好。
