Raffaele Pulli1, Walter Dorigo1, Aaron Fargion1, Giovanni Pratesi2, Domenico Angiletta3, Carlo Pratesi1
1Vascular Surgery, University of Florence, Florence, Italy; 2University of Rome Tor Vergata, Rome, Italy; 3University of Bari, Bari, Italy.
OBJECTIVES: To retrospectively analyze early and late results of endovascular management of aorto-iliac obstructive disease with the kissing stent technique in a single centre experience.
METHODS: From January 2000 to September 2012, 276 consecutive endovascular interventions for aorto-iliac obstructive disease were performed at our institution. In 45 patients the kissing stent technique at the level of aortic bifurcation was performed (Group 1) while in the remaining 231 it was not (Group 2). Early results in the two groups were compared with χ2 test. Follow-up results were analyzed with Kaplan-Meyer curves and compared with log rank test.
RESULTS: There were no differences between the 2 groups in terms of demographic data, comorbidities, risk factors for atherosclerosis and clinical status at the time of the interventions. TASC-II C and D lesions were present in 64% of patients in Group 1 and in 25.5% in Group 2 (p<0.001). The mean number of placed stents was 2.4 in Group 1 and 1.4 in Group 2 (p<0.001). Technical success was 100% in Group 1 and 98% in Group 2 (p=0.3). Local complications occurred in three patients in Group 1 and in 7 patients in Group 2 (p=0.2). No perioperative deaths occurred; perioperative thrombosis rate was 0.9% in Group 2, while no perioperative thrombosis occurred in group 1. Mean duration of follow-up was 30 months (range 1 month-12 years). Primary patency rates at 4 years were 82% (SE 0.08) in Group 1 and 77% (SE 0.05) in Group 2 (p=0.9). At the same time interval, also assisted primary and secondary patency and survival rates were similar; reintervention rates were 13% in Group 1 (SE 0.08) and 15.8% in Group 2 (SE 0.04; p=0.2).
CONCLUSIONS: In our experience, the kissing stent technique provided satisfactory early and follow-up results in patients with obstructive aorto-iliac diseases, representing an effective solution in complex anatomies.
AUTHOR DISCLOSURES: D. Angiletta: Nothing to disclose; W. Dorigo: Nothing to disclose; A. Fargion: Nothing to disclose; C. Pratesi: Nothing to disclose; G. Pratesi: Nothing to disclose; R. Pulli: Nothing to disclose.
Posted April 2013