Kissing stents in the aortic bifurcation.

Published

Journal Article

BACKGROUND: We report the first series of simultaneously delivered stents used to treat stenosis of the aortic bifurcation. Surgical treatment of aortoiliac occlusive disease carries up to a 3% mortality rate. Percutaneous balloon techniques to treat aortic bifurcation stenosis, although safer, are still associated with up to a 9% incidence of dissection, thrombosis, or significant residual stenosis. Kissing stent insertion should decrease the incidence of these complications. METHODS: Twenty patients underwent kissing stent insertion. Suitable candidates included patients with symptoms of lower limb ischemia and significant atherosclerotic lesions in both ostial common iliac arteries (n = 15) or with extremely complex single ostial iliac stenoses (n = 5). Palmaz stents were delivered simultaneously to both limbs of the aortic bifurcation. RESULTS: Kissing stent insertion was successfully performed in all 20 patients without acute complications. Mean percent stenosis decreased from 46.2%+/-24.8% to -6.8%+/-13.3% (P = .0001) in the right iliac artery, 42.3%+/-22.8% to -1.6% +/-18.1% (P = .0001) in the left iliac artery, and 19.1%+/-16.6% to 2.3%+/-16.4% (P= .0008) in the distal aorta. Intermittent claudication symptoms were improved in 18 (95%) of 19 patients with 12 (63%) of 19 patients becoming totally asymptomatic. The strongest predictor of clinical outcome after kissing stent insertion was the preprocedural extent of femoropopliteal disease: 8 (89%) of 9 patients with femoropopliteal narrowing <75% bilaterally became completely asymptomatic at follow-up compared with only 3 (30%) of 10 patients with more severe stenoses (P = .02). CONCLUSIONS: We have demonstrated in 20 patients that stenoses of the aortic bifurcation can be treated effectively with kissing stents with few serious adverse events.

Full Text

Duke Authors

Cited Authors

  • Mendelsohn, FO; Santos, RM; Crowley, JJ; Lederman, RJ; Cobb, FR; Phillips, HR; Weissman, NJ; Stack, RS

Published Date

  • October 1998

Published In

Volume / Issue

  • 136 / 4 Pt 1

Start / End Page

  • 600 - 605

PubMed ID

  • 9778061

Pubmed Central ID

  • 9778061

International Standard Serial Number (ISSN)

  • 0002-8703

Digital Object Identifier (DOI)

  • 10.1016/s0002-8703(98)70005-5

Language

  • eng

Conference Location

  • United States