Long-term results after primary stenting of distal aortic stenosis.
OBJECTIVE
To review the long-term results of primary stent placement in the distal aorta above the bifurcation.


METHODS
Fourteen patients (8 men; mean age 62 years, range 46-82) underwent primary stent implantation performed by an interdisciplinary radiosurgical team. In 10 patients, a long-term follow-up examination consisting of patient history, clinical examination, and duplex sonography was performed. The ankle-brachial index (ABI) for the posterior tibial artery was calculated on the basis of Doppler pressure measurements.


RESULTS
The clinical success rate at the first follow-up examination (mean 2.9 months, range 2.1-4.4) was 100% (n = 14). The mean baseline ABI of 0.64 +/- 0.12 had risen to 1.02 +/- 0.10 (p < 0.0001). At midterm follow-up (mean 22.8 months, range 14-42) in 12 patients, the ABI was 0.96 +/- 0.12 (p < 0.0001 versus baseline). At a mean 86 months (range 51-119) after stent treatment, the ABI in 10 patients was 0.90 +/- 0.20 (p < 0.0001 versus baseline). Over the long term, the clinical success rate was 70%. Deterioration was due to the progression of atherosclerosis distal to the aorta; duplex sonography showed no aortic restenosis or occlusion.


CONCLUSIONS
In view of the excellent long-term results in our small series, primary stent placement in focal abdominal aortic stenosis in properly selected patients is a durable treatment. In addition, the mortality and morbidity risks are markedly reduced compared with open surgery.
Ruppert
Volker
V
Department of Vascular Surgery, Hospital of Ludwig-Maximilian University Munich-Campus Innenstadt, Munich, Germany. Volker.Ruppert@med.uni-muenchen.de
Wirth
Stefan
S
Rieger
Johannes
J
Kueffer
Georg
G
Steckmeier
Bernd
B
Stoeckelhuber
Beate M
BM
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D015607:Stents; D016896:Treatment Outcome; D014463:Ultrasonography; D014654:Vascular Patency