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RESEARCH PRODUCT

Long-Term Results of Stenting of the Aortic Bifurcation

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Background To evaluate the long-term results in a multicentric continuous series of narrowing lesions of the aortic bifurcation treated with a kissing stent. Methods From January, 1st 1999 to the December, 31st 2001, all of the patients ( n = 80) presenting with stenosis of the aortic bifurcation ( n = 15) and/or the 2 common iliac arteries ( n = 65), treated with a kissing stent, in 8 teaching hospitals were collected retrospectively. The risk factors were smoking (91%), dyslipidemia (60%), arterial hypertension (42%) and diabetes (27%). In 84% of cases, the indication for treatment was claudication. The lesions were stenotic n = 76) and/or thrombotic ( n = 18). The associated lesions were external iliac stenoses ( n = 21), common femoral stenoses ( n = 19), femoro-popliteal stenoses ( n = 42), arteriopathy in the leg ( n = 35). Follow-up was clinical examination and Doppler US scan. Results The success rate of the technique was 89%. There were 4 cases (5.3%) of residual stenosis and 4 cases (5.3%) of dissection. The length of the lesions treated in the aorta and the iliac arteries was respectively 17.1 ± 7 and 17.3 ± 9 mm. The stents were all placed as kissing stents, and had a mean diameter and a mean length of 13.75 mm and 56 mm in the aorta and 9 mm and 48 mm in the iliac arteries, respectively. At 5 years, 19 patients had required repeat angioplasty in the treated area, and 13 had undergone open surgery. Primary and assisted primary patency at 5 years were 64.5% and 81.8%, respectively. Conclusion Long-term follow-up of endovascular treatment with kissing stents for stenosis of the aortic bifurcation shows that this technique gives good results, though it does not justify doing away with classical revascularisation surgery, in a population with major cardiovascular risk factors.