Placement of Hemobahn stent-grafts in femoropopliteal arteries: early experience and midterm results in 18 patients.
OBJECTIVE
To determine the outcome of a new polytetrafluoroethylene (PTFE)-covered stent-graft in the treatment of occlusive lesions of the femoropopliteal arteries.


METHODS
Eighteen patients with intermittent claudication (Fontaine stages IIb-IV; Rutherford classes I/2-III/5) and occlusive lesions of the superficial femoral and/or popliteal artery were treated with use of a new PTFE-covered stent-graft (Hemobahn). Indication for stent-graft insertion was an unsatisfactory result after balloon dilation.


RESULTS
Successful stent-graft placement was achieved in 17 patients (94%). In one patient, additional insertion of a Palmaz stent was necessary because of a stent-graft wrinkle. Mean ankle-brachial index increased from 0.72 +/- 0.15 preoperatively to 0.94 +/- 0.17 postoperatively (P =.028). Fifteen patients (83%) experienced an initial improvement of at least one clinical stage. Primary patency was 61% +/- 11% at 3 months and 49% +/- 12% at 6 months. Stent-graft occlusion was observed in 13 patients (72%). In four patients, the stent-graft was reopened percutaneously by balloon angioplasty (n = 2) and/or rotational thrombectomy (n = 2). Therefore, the secondary patency rate was 67% +/- 11% at 3 months and 61% +/- 11% at 6 months. Patency rates proved to be significantly lower for stent-grafts longer than 10 cm (P =.03). Intimal hyperplasia at the proximal or distal end of the stent-graft was observed in seven patients (39%). Complications such as access site hematoma (n = 3), distal thromboembolism (n = 2), and abscess formation around the stent-graft (n = 1) were observed.


CONCLUSIONS
Despite excellent initial angiographic results, the patency rate in lesions treated with the Hemobahn stent-graft in this small study was unsatisfactory. Use of stent-grafts longer than 10 cm and the occurrence of intimal hyperplasia proved to be major factors in the reduction of long-term patency rates.
Deutschmann
H A
HA
Department of Radiology, University Hospital Graz, Auenbruggerplatz 9, A-8036 Graz, Austria.
Schedlbauer
P
P
Bérczi
V
V
Portugaller
H
H
Tauss
J
J
Hausegger
K A
KA
D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007383:Intermittent Claudication / Q000150:complications; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency
D011138:Polytetrafluoroethylene