Percutaneous reconstruction of the aortoiliac bifurcation with the "kissing stents" technique: long-term follow-up in 106 patients.
OBJECTIVE
To evaluate the long-term results using the kissing stents technique for treatment of occlusive disease involving the aortoiliac bifurcation.


METHODS
One hundred six patients (97 men; mean age 52.5 +/- 10.2 years, range 33-78) were treated with the kissing stents technique for bilateral aortoiliac stenosis (55, 51.9%), unilateral occlusion of the common iliac artery (CIA) with contralateral stenosis (47, 44.3%), and bilateral CIA occlusion (4, 3.8%). Clinical examination and duplex scans were performed prior to discharge and at 1, 6, and 12 months, followed by yearly examinations thereafter.


RESULTS
Bilateral stent implantation was successful in all patients. No major procedure-related complications were observed. Self-expanding stents were deployed in 62 (58.5%) patients and balloon-expandable devices in 44 (41.5%). Fifteen (7.1%) hematomas were observed at the 212 access sites. Mean follow-up was 30.1 +/- 11.1 months (range 12-137). Duplex imaging diagnosed significant (>50%) restenosis in 15 (14.8%) of 101 patients and reocclusion in 4 (4%); 17 (89.5%) of these patients had recurrent symptoms and all were retreated (endovascular procedure in 18 and an aortobifemoral bypass in 1). Primary and secondary cumulative patency rates at 36 months were 79.4% and 97.7%, respectively. Balloon-expandable stents had a nonsignificantly higher patency rate compared to self-expanding stents.


CONCLUSIONS
Based on our experience, aortoiliac endovascular reconstruction with the kissing stents technique is a safe and effective procedure, representing an alternative to conventional surgery in selected patients.
Haulon
Stéphan
S
Department of Vascular Surgery, Hôpital Cardiologique, CHRU de Lille, 59038 Lille Cedex, France.
Mounier-Véhier
Claire
C
Gaxotte
Virginia
V
Koussa
Mohamad
M
Lions
Christophe
C
Haouari
Ben Ahmed
BA
Beregi
Jean-Paul
JP
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002404:Catheterization / Q000379:methods; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015607:Stents; D014654:Vascular Patency