Endovascular treatment of atherosclerotic lower limb lesions using a PTFE-collared stent-graft.
OBJECTIVE
To assess the feasibility of a polytetrafluoroethylene-collared (PTFE) endoluminal graft in the treatment of lower limb atherosclerosis.


METHODS
We designed an endograft using a 3-mm-diameter balloon-expandable PTFE graft with terminal Palmaz stents placed on the outside of the graft, folding the PTFE back over the stents to form a collar at each end. Under protocol, this device was implanted in 8 symptomatic patients with lower limb ischemia. The lesions, ranging from 4 to 20 cm long, were located in the superficial femoral artery (n = 5), femoropopliteal segment (n = 1), and common (n = 1) and external (n = 1) iliac arteries. The device required a 14-F introducer system.


RESULTS
Graft lengths varied from 4 to 35 cm. Implantation was successful in all cases, but procedural complications occurred in 4 patients (2 access site hematomas, 1 leading to endograft occlusion; 1 arterial injury, and 1 distal thromboembolism). At a mean 14-month follow-up, 5 endografts were patent (2 after reintervention for restenosis or thrombosis). The common iliac endograft and 2 superficial femoral artery devices occluded after 3, 2, and 12 months, respectively.


CONCLUSIONS
Although this endoluminal graft system is technically feasible and showed encouraging intermediate-term patency in a small pilot study, the early and late complications identified several shortcomings of this design, which needs refinement.
Lundquist
P B
PB
Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
Kalin
B
B
Olofsson
P
P
Swedenborg
J
J
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001672:Biocompatible Materials; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D002404:Catheterization / Q000295:instrumentation; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery; D007511:Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery; D011474:Prosthesis Design; D015607:Stents
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene