San Norberto Enrique M, Revilla Álvaro, Brizuela José A, Del Blanco Isabel, Flores Ángel, Taylor James H
Department of Angiology and Vascular Surgery, Valladolid University Hospital, 47003 Valladolid, Spain.
Department of Angiology and Vascular Surgery, Toledo University Hospital, 45007 Toledo, Spain.
J Clin Med. 2024 Mar 26;13(7):1925. doi: 10.3390/jcm13071925.
: This study examines the impact of the use of the combination of BeGraft and Solaris stent grafts on the outcomes during the covered endovascular reconstruction of aortic bifurcation (BS-CERAB) technique and extension to the iliac arteries. : Consecutive patients with aortoiliac occlusive disease who underwent endovascular treatment using BS-CERAB between January 2020 and December 2023 were included. Patient demographics, symptoms, lesion characteristics, and procedural and follow-up details were collected and analyzed. Perioperative complications and reinterventions were also identified. : A total of 42 patients met the inclusion criteria (32 men, 76.2%, median age 72 years, range 59-85). Indications for treatment were intermittent claudication (42.9%) and critical limb ischemia (57.1%). Procedure success was achieved in all cases. The median patient follow-up time was 14 months (1-36). One patient died at a 10-month follow-up due to lung cancer. The mean pre-operative ABI increased from 0.37 ± 0.19 before intervention to 0.71 ± 1.23 post-operatively at 12 months ( = 0.037). The estimated primary patency rates at 3, 6, and 12 months were 90.5%, 85.7%, and 81.0% and primary assisted patency rates were 90.5%, 90.5%, and 85.7%, respectively. Secondary patency was 95.2% at 3 and 6 months and 90.5% at a 12-month follow-up. Active cancer ( = 0.023, OR 2.12 95%CI 1.14-3.25) was a risk factor for restenosis. : This mid-term experience shows that the CERAB technique using the combination of BeGraft and Solaris stents grafts, for the endovascular treatment of severe aortoiliac atherosclerotic disease, may allow an effective reconstruction of the aortic bifurcation and iliac arteries related to high-patency and lower-reintervention rates.
本研究探讨了在主动脉分叉部覆膜血管腔内重建术(BS-CERAB)技术及向髂动脉延伸过程中,联合使用BeGraft和Solaris覆膜支架对手术结果的影响。纳入2020年1月至2023年12月期间采用BS-CERAB进行血管腔内治疗的连续性主髂动脉闭塞性疾病患者。收集并分析患者的人口统计学资料、症状、病变特征、手术及随访细节。同时确定围手术期并发症和再次干预情况。共有42例患者符合纳入标准(32例男性,占76.2%,中位年龄72岁,范围59 - 85岁)。治疗指征为间歇性跛行(42.9%)和严重肢体缺血(57.1%)。所有病例手术均成功。患者中位随访时间为14个月(1 - 36个月)。1例患者在10个月随访时因肺癌死亡。术前平均踝肱指数(ABI)从干预前的0.37±0.19增加到术后12个月时的0.71±1.23(P = 0.037)。3个月、6个月和12个月时的估计原发性通畅率分别为90.5%、85.7%和81.0%,原发性辅助通畅率分别为90.5%、90.5%和85.7%。3个月和6个月时的继发性通畅率为95.2%,12个月随访时为90.5%。活动性癌症(P = 0.023,OR 2.12,95%CI 1.14 - 3.25)是再狭窄的危险因素。这项中期经验表明,采用BeGraft和Solaris支架联合的CERAB技术用于严重主髂动脉粥样硬化疾病的血管腔内治疗,可能实现主动脉分叉和髂动脉的有效重建,且具有高通畅率和低再次干预率。