title: Primary stenting for aortic lesions: from single stenoses to total aortoiliac occlusions.
abstract: OBJECTIVE
  This study evaluated the feasibility, safety, and efficacy of primary stenting in atherosclerotic stenoses and occlusions of the infrarenal aorta.
  
  
  METHODS
  Between January 2003 and December 2006, 12 patients (6 men) with a mean age of 66.3 +/- 4.1 years who had infrarenal aortic occlusive disease were treated with primary stenting (aortic stenosis, 8; chronic total aortobiiliac occlusion, 4). Reasons for referral were severe claudication in six patients (50%), ischemic rest pain in four (33.3%), and minor tissue loss in two (16.7%). Three patients (25%) had chronic renal failure and were on dialysis. Follow-up was performed in all 12 patients.
  
  
  RESULTS
  Technical success was 91.7% because one patient had a residual stenosis >30% after stent placement and balloon postdilation owing to severe calcification of the aorta. However, clinical and immediate hemodynamic success was achieved in all 12 patients (100%). The preprocedural mean resting ankle-brachial index (ABI) values of 0.56 +/- 0.13 at the right side and 0.59 +/- 0.15 at the left were increased to 0.97 +/- 0.04 and 0.95 +/- 0.06, respectively, after treatment (P < .01). At the end of the mean follow-up of 18.3 months (range, 6-37 months), the primary clinical and hemodynamic patency was 91.7% +/- 7.98%, and the mean resting ABI values were 0.96 +/- 0.04 for the right and 0.92 +/- 0.1 for the left side (P < .01 compared with preinterventional values). None of the patients in the study underwent reintervention. An access-related groin hematoma developed in one patient, but no other major or minor complications occurred. One patient died 8 months after the procedure of chronic renal failure complications.
  
  
  CONCLUSIONS
  Primary stenting is feasible, safe, and effective for the whole spectrum of aortic occlusive disease. Especially for patients with infrarenal aortic stenoses, it is recommended as the first-line treatment and should be considered as a viable alternative to surgery for total aortoiliac occlusions.
authors.affiliation: First Department of Surgery, Vascular Division, LAIKON Hospital, Athens University Medical School, Athens, Greece. chris_klonaris@yahoo.com <chris_klonaris@yahoo.com>
authors.forename: Chris
authors.initials: C
authors.lastname: Klonaris
authors.forename: Athanasios
authors.initials: A
authors.lastname: Katsargyris
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tsekouras
authors.forename: Andreas
authors.initials: A
authors.lastname: Alexandrou
authors.forename: Athanasios
authors.initials: A
authors.lastname: Giannopoulos
authors.forename: Elias
authors.initials: E
authors.lastname: Bastounis
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D001027:Aortography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D003251:Constriction, Pathologic; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency