Aortic Bifurcation Reconstruction: Use of the Memotherm Self-Expanding Nitinol Stent for Stenoses and Occlusions
- Directorate of Clinical Radiology, Dundee Teaching Hospitals NHS Trust, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland (United Kingdom)
- Department of Vascular Surgery, Dundee Teaching Hospitals NHS Trust, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland (United Kingdom)
Purpose: To assess the technical success, initial clinical outcome, and intermediate follow-up of the Memotherm nitinol self-expanding stent in aortic bifurcation reconstruction. Methods: Thirty-three patients (13 male, 20 female), mean age 64 years, were treated, who had symptoms classified by the Surgical Vascular Society/International Society of Cardiovascular Surgery (SVS/ICVS) classification as grade 2 in 11 (33%), grade 3 in 19 (58%) and grade 4 in 3 (9%) patients. Lesions were classified according to severity and type. Indications for placement of a Memotherm nitinol self-expanding stent were failed angioplasty in 14 (42%), chronic occlusions in 12 (37%), and complex stenoses in seven (21%) patients. Results: Sixty-seven stents were technically successfully placed in 66 aorto-iliac segments in 33 patients, with one major complication. Initial clinical outcome was improvement in 25 (81%), no change in four (13%), and a worsening in two (6%) patients by Rutherford criteria. Mean early ankle/brachial pressure index (ABI) gain was 0.27 for occlusions and 0.05 for stenoses. Clinical follow-up was obtained in all patients, with retrospective angiographic follow-up in 28 (85%) at a mean of 16 months (range 12-26 months). The decrease in ABI and the decrease in angiographic luminal diameter at follow-up was determined as the 'late loss.' The mean ABI late losses were -0.06, 0.00, and 0.09, and the mean angiographic late losses were 6.7%, 10% and 14% for occlusions, stenoses, and normal segments respectively. Primary clinical patency was 96%, primary angiographic patency was 89%, and secondary angiographic patency was 93%. Conclusion: The high technical success of stent placement, the low complication rates for aortic bifurcation reconstruction using the Memotherm self-expanding stent, and high clinical and angiographic patency maintained at intermediate follow-up support their use in aortic bifurcation reconstruction.
- OSTI ID:
- 21080329
- Journal Information:
- Cardiovascular and Interventional Radiology, Vol. 22, Issue 2; Other Information: DOI: 10.1007/s002709900341; Copyright (c) 1999 Springer-Verlag New York Inc; Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
- Country of Publication:
- United States
- Language:
- English
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