Cor Vasa 2003, 44(9):421-426
Endovascular therapy of diffuse atherosclerotic disease involving of the aortoiliac area using the stentgraft
- 1 Oddělení cévní chirurgie
- 2 Radiodiagnostické oddělení, Nemocnice Na Homolce, Praha, Česká republika
Aim of study:
To assess the results of endovascular therapy of diffuse atherosclerotic disease involving the aortoiliac area using stentograft.
Patients and methods:
A group of 11 at-risk patients receiving this therapy from the very start through 1999. The patients were 8 men and 3 women with a mean age of 65 years (35-79 years). Mean follow-up period was 34 months (36-26). Patients were indicated for surgery for peripheral artery disease of IIb-III functional class according to Fontaine. The method was used both as an alternative to axillofemoral bypass or aortofemoral bypass in the presence of high risk for anatomical aortofemoral reconstruction.
The stentgraft consists of a self-expandable conic stent whose thinner end is covered with a fixed, pre-dilated 6-mm think-walled ePTFE prosthesis. The first step is angioplasty of the aortoiliac area showing diffuse involvement. The stentgraft is inserted into the aorta or the pelvic artery, under angiographic guidance, from arteriotomy on the common femoral artery using 16F instrumentarium.
Results:
Overall, we implanted 12 stentgrafts (aortofemoral stentgraft in 4 cases; aortoprofundal and ilicofemoral stentgrafts in 3 cases each; a cover stent implanted into the pelvic artery in two cases). One patient died after surgery (9%). The long-term stentgrafts patency was 83%; all patients report a decrease in the class of complaints.
Conclusion:
Endovascular therapy using the stentgraft in selected at high risk patients with aortoiliac atherosclerosis is advantageous. Compared with conventional vascular surgery, the main advantage is that it is less invasive making it suitable even for at-risk patients.
The introduction and use of new instrumentaria (rotablators and strippers), allowing distant atherosclerotic plaque endarterectomy will allow a wider use of these new endovascular methods.
Keywords: Stentgraft; Endovascular therapy; Aortoiliac reconstruction
Published: September 1, 2003 Show citation