Outcomes of Endovascular Reconstructive Techniques in Trans-Atlantic Inter-Society Consensus II C-D Aortoiliac Lesions

Zacà, Sergio; Desantis, Claudio; Stefano, Lucia Di; Pulli, Raffaele; Angiletta, Domenico

doi:10.1016/j.avsg.2022.10.022

Cited by 4 publications

(5 citation statements)

References 21 publications

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“…18 Same data were observed also in 2 italian papers on aorto-iliac obstructions. 19,20 The unibody anatomical features allowed to guarantee subsequent possibility for cross-over interventions and to perform endovascular reconstructions especially when the reentry zone distally to an obstruction was located nearly an arterial bifurcation. 21 We straightened the concept of hypogastric salvage for several concepts.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Bailout Repair After Intraprocedural Thrombosis of a Bifurcated Unimodular Stent-graft During Aorto-iliac Revascularization in a Patient with Sars CoV-2 Infection

Zacà

Ramundo

Desantis

et al. 2023

Vasc Endovascular Surg

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To describe a case of endovascular bailout strategy during stent-graft thrombotic complication in an endovascular procedure for complex TASC II D aortoiliac lesion. A 77-year-old patient was admitted at our institution with bilateral lower limb rest pain due to aortoiliac obstructive disease in a previous aortobifemoral bypass grafting with an asymptomatic Sars-CoV-2 infection. We planned an anatomic reconstruction of the aortoiliac segment with an unimodular bifurcated stent-graft. During the procedure, we observed a preocclusive thrombosis of the aortic portion requiring endovascular thrombectomy with vacuum assisted system followed by a successfully kissing-stent endolining. The post-operative period was uneventful and patient was discharged on the 14th post-operative day. Endovascular thrombectomy may be a helpful strategy during thrombotic complication of complex reconstructions of obstructive aortoiliac disease avoiding surgical conversion to laparotomy.

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Section: Discussionmentioning

confidence: 99%

Endovascular Bailout Repair After Intraprocedural Thrombosis of a Bifurcated Unimodular Stent-graft During Aorto-iliac Revascularization in a Patient with Sars CoV-2 Infection

Zacà

Ramundo

Desantis

et al. 2023

Vasc Endovascular Surg

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“…The procedure is a challenging endovascular intervention that requires operators' experience. 19,20 Flow separation and shear stress occurring with aortoiliac KS lead to increased neointimal proliferation and thrombus formation. CERAB technique was presented as a more physiological and anatomical way of reconstruction of the aortic bifurcation.…”

Section: Discussionmentioning

confidence: 99%

“… 7 , 17 There are limited high-quality evidence related to use of CBE stents in TASC C and D lesions involving the aortic bifurcation. 18 , 19 The first randomized controlled COBEST trial comparing BMS and CBE stents, reported that CBE stents showed superior patency in TASC C and D lesions at 18 months and showed similar patency for TASC B lesions. 17 The recent guideline of the Society for Cardiovascular Angiography and Interventions strongly recommended to use balloon expandable BMS and CBE stents over self-expandable BMS in the treatment of aortoiliac bifurcation lesions.…”

Section: Discussionmentioning

confidence: 99%

“…The procedure is a challenging endovascular intervention that requires operators’ experience. 19 , 20 …”

Section: Discussionmentioning

confidence: 99%

“… 29 Recent studies reported endovascular patency rates approximating those of open surgery for type C or D lesions. 18 , 19 , 30 – 33 Hinnen et al reported long-term results of KS in aortic bifurcation. Primary, primary assisted and secondary patency rate was, 70%, 81% and 91% respectively at 5 years, and 67%, 81%, and 91% at 10 years.…”

Section: Discussionmentioning

confidence: 99%

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Results of endovascular treatments of Trans-Atlantic Inter-Society Consensus C or D aortoiliac occlusive disease involving the aortic bifurcation

Amanvermez Senarslan,

Yildırım,

Bayram

et al. 2023

SAGE Open Medicine

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Objectives: The current study aims to report midterm results of patients treated with endovascular intervention, kissing stent, or covered endovascular reconstruction of the aortic bifurcation, for Trans-Atlantic Inter-Society Consensus C or D aortoiliac occlusive disease involving the aortic bifurcation. Methods: Eighteen patients who have intermittent claudication or chronic limb threatening ischemia with Trans-Atlantic Inter-Society Consensus C or D aortoiliac occlusive disease involving the aortic bifurcation enrolled to the study between January 2018 and January 2021. Kissing stents, Advanta V12 (Atrium, Getinge Group), were used in 13 patients, and the covered endovascular reconstruction of the aortic bifurcation technique was used in 4 patients to reconstruct the aortic bifurcation. The patients were followed for a median of 49 months (min. 2, max.58 months). Patency rates, mortality, morbidities, and reinterventions were recorded. Results: The mean age of the patients was 60.4 ± 10 years. Technical success was achieved in 94.4% of the patients, but one patient had to convert to open surgery. Primary patency rate of the remaining patients was 85.6% at 58 months. Target lesion revascularization rate was 11.7%. One patient had successful reintervention for in stent restenosis, and secondary patency rate was 93.3% at 58 months. Limb salvage rate was 84.6% during the follow-up. Two patients had myocardial infarction (11.1%) and one mortality (5.6%) occurred because of cerebrovascular event in the follow-up. Conclusions: Endovascular techniques can be used safely for reconstruction of the aortic bifurcation in Trans-Atlantic Inter-Society Consensus C or D aortoiliac occlusive disease in selected patients who have high risk for open surgery. Covered endovascular reconstruction of the aortic bifurcation is the only technique that showed patency rates approaching open surgery in treatment of aortoiliac occlusive disease involving the aortic bifurcation to date. Although promising patency results were achieved with kissing-covered stents, long-term patency rates were still lower than those achieved with open surgery. Further randomized controlled studies comparing the long-term results of these techniques are needed.

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Robot-assisted vascular surgery: literature review, clinical applications, and future perspectives

Lengyel,

Chinnadurai,

Corr

et al. 2024

J Robotic Surg

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Outcomes of Endovascular Reconstructive Techniques in Trans-Atlantic Inter-Society Consensus II C-D Aortoiliac Lesions

Cited by 4 publications

References 21 publications

Endovascular Bailout Repair After Intraprocedural Thrombosis of a Bifurcated Unimodular Stent-graft During Aorto-iliac Revascularization in a Patient with Sars CoV-2 Infection

Endovascular Bailout Repair After Intraprocedural Thrombosis of a Bifurcated Unimodular Stent-graft During Aorto-iliac Revascularization in a Patient with Sars CoV-2 Infection

Results of endovascular treatments of Trans-Atlantic Inter-Society Consensus C or D aortoiliac occlusive disease involving the aortic bifurcation

Robot-assisted vascular surgery: literature review, clinical applications, and future perspectives

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