Our Experience with 140 Visceral Artery Stents: Should Celiac Artery Stenting be Abandoned?

Abstract

years) and 125 women (mean age, 70.0 Ϯ 11.2 years; P ϭ NS). Women were more likely to undergo treatment for critical limb ischemia (87.7% vs 77.7%; P ϭ .028) and less likely to have treatment for claudication (12.3% vs 22.3%; P ϭ NS). Women were also more likely to undergo balloon angioplasty (57.5% vs 68.9%; P ϭ .043). However, men were more likely to have coronary disease, history of coronary bypass grafting, and chronic renal insufficiency. TransAtlantic Intersociety Consensus distribution, incidence of smoking, and diabetes were equivalent in both sexes. When adjusted for comorbidities, women had higher 24-month primary patency rates (46.0% Ϯ 6.1% vs 30.4% Ϯ 5.9%; P ϭ .016) and limb salvage rates (87.5% Ϯ 4.1% vs 82.9% Ϯ 5.4%; P ϭ .041) than men for tibial lesions with concurrent proximal disease. The difference in 24-month patency between women and men was more pronounced for isolated tibial lesions (50.1% Ϯ10.1% vs 28.8% Ϯ 10.4%; P ϭ .002). Although the overall complication rates were similar, women had comparatively higher rates of postoperative access site thrombosis than men (8.9% vs 0.6%, P ϭ .001).Conclusions: Overall, endovascular interventions below the knee are safe and effective in women and should be considered the first-line modality for the management of critical tibial occlusive disease. However, further investigation and development of technique to better fit the female anatomy is necessary to improve the gender-related disparity in access site-related complications.

Middle Aortic Syndrome with Mesenteric artery stenosis- successful percutaneous endovascular reconstruction

“…In our case, SMA was stented rather than CA. As reported by Dahl et al in a study of mesenteric stent series of 140 patients, superior primary patency for SMA (55%) over CA (17%) at 1-year based on ultrasound duplex criteria was observed, which indicates that outcomes depends on primary anatomical target, lesion complexity and number of vessels treated [9]. However, if the SMA cannot be treated by endovascular means (e.g., due to calcification or presence of an ostial or long occlusion), celiac angioplasty may be beneficial [10].…”