Aortic Bifurcation Reconstruction: Use of the Memotherm Self-Expanding Nitinol Stent for Stenoses and Occlusions

Journal Article · Mon Mar 15 04:00:00 EST 1999 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S002709900341· OSTI ID:21080329

Houston, J Graeme ^[1]; McCollum, Peter T; Stonebridge, Peter A; Raza, Zahid ^[2]; Shaw, J William ^[1]

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1. Directorate of Clinical Radiology, Dundee Teaching Hospitals NHS Trust, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland (United Kingdom)
2. 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, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 2 Vol. 22; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIFURCATION
NICKEL ALLOYS
PATIENTS
PHENOBARBITAL
SURGERY
SYMPTOMS
TITANIUM ALLOYS
VASCULAR DISEASES