Long-term results of the heparin-bonded Viabahn stent graft in femoropopliteal TASC C and D lesions with a covered stent length of minimum 25 cm

Vascular ◽  
2019 ◽  
Vol 27 (5) ◽  
pp. 553-559 ◽  
Author(s):  
C Uhl ◽  
A Dadras ◽  
F Reichmann ◽  
T Betz ◽  
N Zorger ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Stent Graft ◽  
Covered Stent ◽  
Long Term Results ◽  
Lesion Length ◽  
Secondary Patency ◽  
Graft Occlusion ◽  
Long Term Outcome ◽  
Stent Length

Background Heparin-bonded covered stent grafts (Viabahn) are used to treat femoropopliteal long-segment arteriosclerotic lesions. The aim of this study was to evaluate the long-term outcome of Viabahn grafts with a covered stent length of minimum 25 cm. Methods We conducted a retrospective analysis of patients receiving a heparin-bonded stent graft in our clinic who met the length criteria between July 2010 and March 2018. Primary endpoints were patency rates, limb salvage and survival after five years. Secondary endpoint was the 30-day outcome including early complications. Results A total of 62 patients (45 male, median age 70.5 years) were included. The median arteriosclerotic lesion length was 25 cm (22.0–41.3 cm), the minimum covered stent length was 25 cm (25–46 cm). All lesions were TASC C and D lesions. The 30-day mortality was 0%, an early stent graft occlusion occurred in 8.1%. A major amputation was performed in 1.6%. Primary patency, primary assisted patency, secondary patency, limb salvage and survival were 38.5%, 45.7%, 52.4%, 92.8% and 68.9% after five years. Distal stent graft end below the femoral condyles and critical limb ischemia was associated with a significant decreased survival. The diameter of the stent had no influence on the outcome. Conclusion The Viabahn stent graft for long segment arteriosclerotic lesions is a feasible treatment with adequate long-term results.

Clinical Experience with a New Nitinol Self-Expanding Stent in Peripheral Arteries

1996 ◽  
Vol 3 (4) ◽  
pp. 369-379 ◽  
Author(s):  
Michel Henry ◽  
Max Amor ◽  
Rafael Beyar ◽  
Isabelle Henry ◽  
Jean-Marc Porte ◽  
...  
Keyword(s):  
Long Term Results ◽  
Lesion Length ◽  
Secondary Patency ◽  
Peripheral Arteries ◽  
External Compression ◽  
Nitinol Stent ◽  
Nitinol Stents ◽  
The Mean

Purpose: To evaluate a new self-expanding nitinol coil stent in stenotic or occluded peripheral arteries. Methods: Seventy-three symptomatic patients (58 men; mean age 67 years) were treated with nitinol stents for lesions in the iliac artery (9 stenoses); superficial femoral artery (SFA) (39 stenoses, 6 occlusions); popliteal artery and tibioperoneal trunk (9 stenoses, 7 occlusions); and 3 bypass grafts. Mean diameter stenosis was 84.4% ± 9.9% (range 75% to 100%), and mean lesion length was 45 ± 23 mm (range 20 to 120 mm). Results: Eighty-eight 40-mm-long stents with diameters between 5 and 8 mm were implanted percutaneously for suboptimal dilation (n = 45); dissection (n = 21); and restenosis (n = 7). All stents but one were implanted successfully; the malpositioned stent was removed, and another stent was successfully deployed. There were 3 (4.1%) failures due to thrombosis at 24 hours. During the mean 16-month follow-up (range to 44 months), 4 restenoses (3 femoral, 1 popliteal) have occurred; 2 were treated with repeat dilation and 2 underwent bypass. Primary and secondary patency rates at 18 months were 87% and 90%, respectively, for all lesions (iliac: 100% for both; femoral: 85% and 88%; popliteal: 87% and 100%). Conclusions: This new nitinol stent seems to be safe and effective with favorable long-term results, even in distal SFA lesions and popliteal arteries. Its flexibility and resistance to external compression allow its placement in tortuous arteries and near joints.

scholarly journals Long-Term Results of Endovascular Femoropopliteal Interventions

2018 ◽  
Vol 27 (03) ◽  
pp. 151-157 ◽  
Author(s):  
Luke Marone ◽  
Robert Hacker
Keyword(s):  
Limb Salvage ◽  
Univariate Analysis ◽  
Limb Ischemia ◽  
Major Amputation ◽  
Long Term Results ◽  
Secondary Patency ◽  
Endovascular Interventions ◽  
Significant Difference ◽  
Societal Consensus

Background and Objective Short-term results of endovascular intervention for femoropopliteal lesions have been extensively reported; however, there exists a paucity of long-term objective data related to outcomes of these interventions. We sought to characterize these long-term results including patency, limb salvage, and mortality. Methods From May 2003 to July 2009, all patients who underwent technically successful endovascular balloon angioplasty and/or stenting for Trans-Atlantic Inter-Societal Consensus (TASC) II B, C, and D lesions were identified in a retrospective fashion. Patient demographics, clinical characteristics, arterial noninvasive data, and angiographic anatomic data were evaluated. Results A total of 236 limbs in 186 patients (mean age 74, range 37–94) were treated. Lesion distributions by TASC II classification B, C, and D were 121 (51.3%), 37 (15.7%), and 78 (33%), respectively. Critical limb ischemia (CLI) was the indication for intervention in 42.4% of patients. Five-year primary and primary-assisted patency rates stratified by TASC II classification were B: 55.1%, 91.9%; C: 37.4%, 74.6%; D: 35.5%, 67%, respectively (p = 0.23). Secondary patency based on TASC II classification was B: 92.9%, C: 83%, and D: 75.9%, respectively. Univariate analysis identified age > 75, CLI, and cerebrovascular disease as predictors for loss of patency. Reinterventions to maintain patency were required in 26.5% of TASC II B, 43.2% of TASC II C, and 25.6% of TASCII D lesions (p = NS) and mean time to reintervention ranged from 22 to 29 months with no significant difference related to TASC II classification. A total of eight limbs (3.38%) were converted to open revascularization with two (0.85%) having a change in their initial preoperatively identified bypass target site. Three limbs (1.27%) required a major amputation during follow-up. Survival at 5 years was 44.3%; CLI and smoking were identified as risk factors for death (hazard ratio [HR] 2.6, 1.75–3.84, p < 0.001, HR 3.33, 1.70–6.52, p < 0.001), respectively. Conclusion Long-term patency of endovascular interventions for complicated femoropopliteal lesions is acceptable across TASC II classification and is associated with excellent limb salvage. Mortality in this patient cohort is significant with CLI and smoking being identified as predictors of death.

Femoropopliteal Arteries: Immediate and Long-term Results with a Dacron-covered Stent-Graft

Radiology ◽  
2002 ◽  
Vol 223 (2) ◽  
pp. 345-350 ◽  
Author(s):  
Ramazanali Ahmadi ◽  
Martin Schillinger ◽  
Thomas Maca ◽  
Erich Minar
Keyword(s):  
Stent Graft ◽  
Covered Stent ◽  
Long Term Results ◽  
Covered Stent Graft

One-Year Follow-up after Implantation of the EverFlex Nitinol Stent in Long Lesions of the Superficial Femoral Artery

Angiology ◽  
2008 ◽  
Vol 60 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Johannes Ruef
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Clinical Stage ◽  
Clinical Results ◽  
Long Term Results ◽  
Lesion Length ◽  
Secondary Patency ◽  
Nitinol Stent

For treatment of complex superficial femoral artery lesions, suitable stent devices are required. The present study details the first long-term results with the long EverFlex nitinol stent. Forty-one EverFlex stents were implanted in 32 patients with either superficial femoral artery occlusions (n = 20) or stenoses (n = 12); mean lesion length was 13.3 cm (range = 8.0–39.0). Patients presented with clinical stage Fontaine IIb (n = 27), III (n = 4), or IV (n = 1). Stent lengths were 10 cm (n = 18), 12 cm (n = 6), or 15 cm (n = 17). Follow-up after 2 months indicated primary and secondary patency rates of 96.9% (n = 31) and 100% (n = 32); ABI improved from 0.57 to 0.91 ( P < .001). After 1 year, revascularization was performed in 6 patients (18.8%). Primary and secondary patency rates were 81.3% (n = 26) and 93.8% (n = 30). In this first long-term evaluation, the long EverFlex nitinol stent achieves excellent clinical results after implantation into complex superficial femoral artery lesions.

Indications and immediate and long-term results of a novel pericardium covered stent graft: Consecutive 5 year single center experience

2015 ◽  
Vol 87 (4) ◽  
pp. 712-719 ◽  
Author(s):  
Gioel Gabrio Secco ◽  
Roberta Serdoz ◽  
Ismail Dogu Kilic ◽  
Gianluca Caiazzo ◽  
Alessio Mattesini ◽  
...  
Keyword(s):  
Stent Graft ◽  
Covered Stent ◽  
Long Term Results ◽  
Single Center ◽  
Single Center Experience ◽  
Covered Stent Graft

Long-term Results of Endovascular AAA Repair Using a Homemade Aortomonoiliac PTFE Device

2002 ◽  
Vol 9 (4) ◽  
pp. 481-487 ◽  
Author(s):  
Hemant Ingle ◽  
Guy Fishwick ◽  
Andrew Garnham ◽  
Matthew M. Thompson ◽  
Peter R.F. Bell
Keyword(s):  
Stent Graft ◽  
Covered Stent ◽  
Long Term Results ◽  
Type I ◽  
Term Survival ◽  
Kaplan Meier ◽  
Primary Success ◽  
Table Analysis ◽  
Type I Endoleak

Purpose: To assess the long-term results of a homemade aortomonoiliac polytetrafluoroethylene (PTFE) device used for endovascular abdominal aortic aneurysm (AAA) repair. Methods: A vascular audit database was interrogated to identify 58 consecutive AAA patients (all men; median age 73 years, range 56–88) who underwent aortomonoiliac stent-graft repair. AAAs were eligible for endovascular treatment if the infrarenal neck was ≥15 mm long and ≤28 mm in diameter. Results: Nine (15.5%) procedures failed, 8 during the procedure and 1 on the 7th postoperative day; 8(13.8%) patients were converted, but one was unfit for surgery. There was one intraprocedural stroke, and 3 (5.2%) patients died within 30 days. The primary success rate (no conversion or mortality) was 79.3%. Over a median follow-up of 45 months (range 23–80), there were 3 (5.2%) graft occlusions, 1 kink requiring stent implantation, and 1 expanding sac without identifiable endoleak. There were 11 (19.0%) endoleaks in 10 patients, 9 type I leaks (2 proximal) and 1 type II. One patient with a distal type I endoleak (treated) also exhibited a type III leak at 2 years, but the sac size had not increased. There was a 40% incidence of bilateral buttock claudication, which was serious in only 1 patient. The long-term survival rate by Kaplan-Meier life-table analysis was 57% at 4 years. Conclusions: Implantation of an aortomonoiliac PTFE device can be achieved with good primary success, and the stent-graft seems durable over the long term. Proximal type I endoleaks are rare, but distal endoleaks from the contralateral common iliac artery can be solved by using a different covered stent.

Percutaneous Endoluminal Treatment of Iliac Occlusions: Long-Term Follow-up in 105 Patients

1998 ◽  
Vol 5 (3) ◽  
pp. 228-235 ◽  
Author(s):  
Michel Henry ◽  
Max Amor ◽  
Gérard Ethevenot ◽  
Isabelle Henry ◽  
Bernard Mentre ◽  
...  
Keyword(s):  
Iliac Artery ◽  
External Iliac Artery ◽  
Primary Patency ◽  
Long Term Results ◽  
Lesion Length ◽  
Secondary Patency ◽  
Long Term Follow Up ◽  
Table Analysis ◽  
Percutaneous Recanalization

Purpose: To evaluate the long-term results of percutaneous recanalization techniques in occluded iliac arteries. Methods: Percutaneous recanalization was attempted in 105 patients (97 men; mean age 56 years, range 34 to 80) with iliac occlusions using thrombolysis (n = 15), excimer laser (n = 4), mechanical thrombectomy (n = 16), balloon angioplasty alone (n = 23), and angioplasty plus stenting (n = 69). The majority of lesions (n = 72) were in the common iliac artery (CIA); 33 were in the external iliac artery (EIA). Results: The primary recanalization rate was 88% (92/105) independent of location (EIA: 90%, CIA: 86%) and lesion length, but dependent on age of thrombus (< 3 months: 100%, > 3 months: 79%, p < 0.02). Complications included 5 (4.8%) cases of distal embolism treated by thromboaspiration or Fogarty balloon embolectomy. Seven (6.7%) early thromboses were treated surgically. Primary and secondary patency rates were calculated at 6 years for all 105 cases and for the 92 recanalized lesions using life-table analysis. Overall, primary patency was 52% (CIA: 58%, EIA: 34%) and secondary 66% (CIA: 74%, EIA: 40%). Lesions < 6 cm had a primary patency of 70%, while those > 6 cm had a 31% rate (p < 0.01). Secondary patencies were 86% and 42%, respectively (p < 0.01). Among recanalized lesions, the primary patency was 61% (CIA: 69%, EIA: 38%) and secondary 77% (CIA: 88%, EIA: 45%; p < 0.05). Lesions < 6 cm had a primary patency rate of 72%, while longer lesions had a primary rate of 44% (p < 0.04); secondary patencies were 89% and 59%, respectively (NS). Primary patency without stent was 57% and with stent 65% (NS); secondary patency without stent was 71% and with stent 82% (NS). Conclusions: Percutaneous recanalization of iliac occlusions represents a true alternative to vascular surgery and a first-line treatment option. Stents have a tendency to improve long-term results and are recommended for routine use in chronic iliac occlusions.

scholarly journals Short and long-term outcome after common femoral artery hybrid procedure in patients with intermittent claudication and chronic limb threatening ischemia

VASA ◽  
2021 ◽  
pp. 1-9
Author(s):  
Sandra Woronowicz-Kmiec ◽  
Thomas Betz ◽  
Ingolf Töpel ◽  
Stefan Bröckner ◽  
Markus Steinbauer ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Limb Salvage ◽  
Femoral Artery ◽  
Common Femoral Artery ◽  
Major Amputation ◽  
Hybrid Procedure ◽  
Secondary Patency ◽  
Term Survival ◽  
Long Term Outcome

Summary: Background: This study aimed to evaluate the differences between the outcomes of patients with intermittent claudication (IC) and chronic limb threatening ischemia (CLTI) who underwent a hybrid procedure comprising common femoral artery endarterectomy and endovascular therapy. Patients and methods: This was a retrospective single-center study of all patients with peripheral arterial occlusive disease (PAD) who underwent the hybrid procedure between March 2007 and August 2018. The primary endpoint was primary patency after 7 years. The secondary endpoints were primary-assisted patency, secondary patency, limb salvage, and survival. Results: During the follow-up period, 427 limbs in 409 patients were treated. A total of 267 and 160 patients presented with clinical signs of IC and CLTI, respectively. The 30-day mortality was 1.4% (IC: 0% vs. CLTI: 3.8%, p=0.001). The overall 30-day major amputation rate was 1.6% (IC: 0% vs. CLTI: 4.4, p=0.001). The rates of primary and secondary patency after 7 years were 63% and 94%, respectively, in the IC group and 57% and 88%, respectively, in the CLTI group; the difference was not significant. Limb salvage (94% vs. 82%, p=0.000) and survival (58% vs. 29%, p=0.000) were significantly higher in the IC group. In a multivariate analysis, CLTI was the only risk factor for major amputation. CLTI and single vessel run-off were risk factors for death. Statin therapy was a protective factor. Conclusions: The hybrid procedure provides excellent results as a treatment option for multilevel lesions in patients with PAD. However, patients with CLTI had a shorter long-term survival and lower limb salvage rate.

Does Conversion of Intended Remote Iliac Artery Endarterectomy Alter the Early and Long-Term Outcome?

Vascular ◽  
2005 ◽  
Vol 13 (6) ◽  
pp. 336-342 ◽  
Author(s):  
Luuk Smeets ◽  
Garmt van der Horn ◽  
Suzanne S. Gisbertz ◽  
Gwan Ho ◽  
Frans Moll
Keyword(s):  
Iliac Artery ◽  
Patency Rate ◽  
Long Term Results ◽  
Secondary Patency ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Secondary Patency Rate ◽  
Group 2 ◽  
Group 1

The purpose of this study was to compare the perioperative and long-term results of initial successful remote iliac artery endarterectomies (RIAEs) with converted procedures. From April 1994 to September 2003, 63 remote endarterectomies of the external and/or common iliac artery were planned in 62 patients (41 males, 42 procedures). The median age was 65 years (range 39–83 years), and the indication for operation was severe claudication in 37 (59%), rest pain in 16 (25%), and gangrene in 10 (16%) procedures. Initial technical success was achieved in 56 (89%) procedures (group 1); seven conversions (group 2) were necessary. In group 1, the 5-year primary patency rate improved from 64 ± 15% to a primary assisted patency of 88 ± 9.3% after percutaneous transluminal angioplasty in 11 patients, with 7 requiring stent placement. The 5-year secondary patency rate was 94 ± 7.4%. The primary and secondary patency rates in group 2 were 86 ± 19% and 100%, respectively. RIAE can be offered to patients with long occlusions of the iliac arteries as a first treatment option. The inherent risk of a possible conversion of an intended RIAE to a more invasive surgical procedure has no significant adverse clinical effect on the early and 5-year clinical outcomes.

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