Long Term Results of Kissing Stents in the Aortic Bifurcation

Hinnen, Jan Willem; Konickx, M. A.; Meerwaldt, Robbert; Kolkert, J. L. P.; Palen, Job van der; Huisman, Ad B.; Geelkerken, R. H.

doi:10.1080/00015458.2015.11681095

Cited by 10 publications

(11 citation statements)

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“…Eight authors responded, 2 could not locate the original data files (articles published before year 2000) and 1 did not have the resources to configure a database. Five authors 3,10,16,21,25 agreed to join and signed clinical investigation and data transfer agreements to formalize the collaboration and expectations. The contributing authors supplied 6 anonymized databases (Sabri et al 21 included 2 separate groups) containing data on 605 (40.9%) patients out of the 1480 identified in the search (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

“…12 The updated search query identified 22 articles. 1–6,8–10,13–25 Authors of 19 articles with contact information were invited by electronic mail to join the consortium, and a communication log was kept to overview all responses. If the authors did not respond to the request, a second letter was sent; if this remained unanswered the study was excluded.…”

Section: Methodsmentioning

confidence: 99%

“…1,2 The long-term outcome, however, has not matched that of open surgery due to a high rate of reinterventions to assure stent patency. 3–6 Data published on the results of KS treatment usually include relatively low sample sizes (mean 63.2, range 18–215), 7 owing to the low prevalence of AIOD. Not only do these sample sizes hamper longer term analysis, but the heterogeneity of included patient groups reduces the comparability with respect to open surgery, though it does provide an opportunity for subgroup analysis.…”

Section: Introductionmentioning

confidence: 99%

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Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease

et al. 2018

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Purpose: To evaluate short- and long-term technical and clinical outcomes after kissing stent treatment of aortoiliac occlusive disease (AIOD) based on an individual participant data (IPD) meta-analysis. Materials and Methods: A search of the Scopus database identified 156 articles on KS treatment of AIOD; of these 22 met the inclusion criteria. Authors of 19 articles with contact information were approached to join an IPD consortium. Eight author groups responded and 5 provided anonymized data for merging into an IPD database. The number of included procedures was equal before and after 2005. The primary study outcome was the cumulative patency at 24 months. Secondary outcomes were patency at up to 60 months, complications, and changes in Rutherford category and ankle-brachial index. The predictive value of stent protrusion length, pre-/postdilation, stent type, and patient demographics on primary patency were examined with Cox proportional hazard modeling; outcomes are reported as the hazard ratio (HR). The Kaplan-Meier method was employed to estimate patency rates. Results: In total, 605 (40.9%) of 1480 patients presented in the literature were included in the IPD analysis. The indication for intervention was intermittent claudication in 84.2% and critical limb ischemia in 15.8%. Lesions were classified as TransAtlantic Inter-Society Consensus (TASC) A or B in 52.8% and TASC C and D in 47.2%. The overall primary patency estimate was 81% at 24 months. Primary patency significantly increased after 2005 (p=0.005). Cox regression analysis revealed only age as a significant predictor of sustained primary patency (HR 0.60, p<0.005). Any previous endovascular intervention (HR 2.52, p=0.02) was the main predictor for loss of secondary patency; history of cardiovascular disease (HR 0.27, p=0.04) was the main predictor of sustained secondary patency. Conclusion: The kissing stent technique has a good safety profile and acceptable patency rates up to 2 years, even in TASC C and D lesions, supporting an endovascular-first approach for AIOD.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease

et al. 2018

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“…We have only used routine angiography in all 4 cases. The overall technical success rate to revascularise partially occluded aorta or aortoiliac disease using retrograde approach is 95% 16, 17, 18, 19, 20. Once revascularised, the midterm and long term patency is encouraging 16 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of transfemoral vs transbrachial approach for angioplastic reconstruction of chronic total aortoiliac occlusion

Damera

Barik

Prasad

2016

Indian Heart Journal

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The angioplasty of chronic total aortoiliac occlusion using transfemoral is controversial. From March 2014 to December 2015, four consecutive patients (4 males; mean age 58.2±6.8 years; age of range 51-65 years) underwent angioplasty and stenting of TASC-D occlusion. In all the cases, we failed to cross from femoral approach. On switching over to left brachial access, angioplasty was done successfully in all. There was no procedural site complication or clinical evidence cerebral thromboembolism. Self-expandable stents were implanted in all with adequate pre and post dilation. Complete revascularisation was achieved in two cases and in other two cases, the angioplasty to the left aortoiliac carina was staged. Therefore, it is better to avoid femoral approach as initial step to cross chronic TASC 2007 type D (chronic total aortoiliac occlusion or called extensive aortoiliac disease) because of failure to cross retrogradely due to subintimal course of guide wire leading to retrograde aortic dissection.

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“…These stents were deployed with the proximal end into the aorta and post-dilated. 11 The second centre solely applied the CERAB technique in case of AIOD using balloon expandable covered stents (Advanta V12, Atrium Maquet, Getinge, Hudson, MA, USA) as previously described. 9 Post-operative anticoagulation consisted of clopidogrel (3–6 months) and acetylsalicylic acid (lifetime) or marcoumar (3 months) and acetylsalicylic (lifetime), for the CERAB and KS groups, respectively.…”

Section: Methodsmentioning

confidence: 99%

In vivo geometry of the kissing stent and covered endovascular reconstruction of the aortic bifurcation configurations in aortoiliac occlusive disease

et al. 2017

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ObjectivesVarious configurations of kissing stent (KS) configurations exist and patency rates vary. In response the covered endovascular reconstruction of the aortic bifurcation configuration was designed to minimize mismatch and improve outcome. The aim of the current study is to compare geometrical mismatch of kissing stent with the covered endovascular reconstruction of the aortic bifurcation configuration in vivo.MethodsPost-operative computed tomographic data and patient demographics from 11 covered endovascular reconstruction of the aortic bifurcation and 11 matched kissing stent patients were included. A free hand region of interest and ellipse fitting method were applied to determine mismatch areas and volumes. Conformation of the stents to the vessel wall was expressed using the D-ratio.ResultsPatients were mostly treated for Rutherford category 2 and 3 (64%) with a lesion classification of TASC C and D in 82%. Radial mismatch area and volume for the covered endovascular reconstruction of the aortic bifurcation group was significantly lower compared to the kissing stent configuration (P < 0.05). The D-ratio did not significantly differ between groups. Measurements were performed with good intra-class correlation. There were no significant differences in the post-procedural aortoiliac anatomy.ConclusionsThe present study shows that radial mismatch exists in vivo and that large differences in mismatch exist, in favour of the covered endovascular reconstruction of the aortic bifurcation configuration. Future research should determine if the decreased radial mismatch results in improved local flow profiles and subsequent clinical outcome.

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Long Term Results of Kissing Stents in the Aortic Bifurcation

Cited by 10 publications

References 0 publications

Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease

Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease

Comparison of transfemoral vs transbrachial approach for angioplastic reconstruction of chronic total aortoiliac occlusion

In vivo geometry of the kissing stent and covered endovascular reconstruction of the aortic bifurcation configurations in aortoiliac occlusive disease

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