AAA 24. Bare-Metal Stents for Leriche Syndrome: Outcomes of 3-Year Follow-up

Abstract

Listen

Translate article

Several recent studies have elucidated that the use of covered stents may improve patency rates compared with bare-metal stents (BMSs) in TransAtlantic Inter-Society Consensus (TASC) C and D aortoiliac occlusive disease patients. However, the evidence for endovascular treatment of Leriche syndrome, a unique category of TASC D lesions, is limited, and the effectiveness of both covered stents and BMSs has not been identified adequately. This study was undertaken to evaluate the acute and long-term results of endovascular treatment of Leriche syndrome with BMSs (Fig 1). Patients with Leriche syndrome treated with BMSs from August 2008 to May 2017 were included and followed up. The primary end point was primary patency rate at 1 year, 2 years, and 3 years. The secondary end points were 1-year, 2-year, and 3-year secondary patency rate, technical success rate, complication rate, procedure-related mortality rate, and clinical status improvement. Twenty patients were included, and the follow-up duration was 34.7 ± 18.7 months (0-72 months). The 1-year, 2-year, and 3-year primary patency rates were 100%, 93.3%, and 85.6%, and secondary patency rates were 100%, 91.7%, and 91.7%, respectively (Fig 2). The 1-year, 2-year, and 3-year freedom from target lesion revascularization rates were 100%, 93.3%, and 93.3%, respectively. The aortoiliac lesions were successfully treated with BMS bilaterally in 17 patients (85.0%) and unilaterally in another 3 patients (15.0%). The complication rate was 10.0% (one for acute kidney injury and the other for groin hematoma), and the procedure-related mortality rate was 0%. Mean ankle-brachial index increased significantly from 0.43 ± 0.20 before the procedure to 0.95 ± 0.21 after the procedure (P < .001) and to 1.00 ± 0.19 at the end of the follow-up (P < .001). Improvement in symptoms by at least one Rutherford category occurred in most patients both after the endovascular procedure (95.0%) and at the end of the follow-up period (88.2%). Endovascular treatment with BMSs is effective and safe for patients with Leriche syndrome according to the results of 3-year follow-up.Fig 2Primary patency, secondary patency, and freedom from target lesion revascularization (ffTLR) rates of endovascular treatment of Leriche syndrome with bare-metal stent (BMS).View Large Image Figure ViewerDownload Hi-res image Download (PPT)