Low-profile primary stent placement for the treatment of focal calcified ulcerated stenosis in the infrarenal aorta.
OBJECTIVE
To analyze the immediate and midterm success of low-profile stent placement in calcified ulcerated lesions of the infrarenal aorta in patients with arterial occlusive disease.


METHODS
In this prospective case series, 13 symptomatic patients (eight men, five women; mean age, 64.8 years +/- 12.1; age range, 44-84 years) with focal calcified ulcerated stenoses of the infrarenal aorta were treated with stent placement by using a low-profile technique in a radiology intervention center during a 4-year period. Clinical examinations and duplex ultrasonography were used to evaluate the stents? patency and clinical success. Kaplan-Meier graphs were calculated to analyze the freedom-of-symptom rate.


RESULTS
The initial technical success rate was 92% (12 of 13 patients). Due to extended calcifications, a residual stenosis of 50%-60% remained in one patient. No peri-interventional complications occurred. The mean follow-up was 26 months (range, 5-53 months). During follow-up, one patient had a restenosis after 7 months and presented clinically with Fontaine stage IIb. Two patients had iliac and/or femoral stenoses, and both presented with Fontaine stage IIb. One patient's symptoms originated from the lumbar spine. Primary patency and primary clinical success rates were 85% and 69%, respectively. According to Kaplan-Meier tables, the freedom-from-symptom rates were 92%, 84%, 73%, and 63% at 0, 7, 12, and 21 months, respectively.


CONCLUSIONS
Low-profile stent placement in calcified, ulcerated lesions of the infrarenal aorta is an effective and safe treatment for symptomatic stenoses in patients with arterial occlusive disease after a mean follow-up of 26 months.
Schaefer
Philipp J
PJ
Department of Diagnostic Radiology, University Hospital Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel, Germany. jp.schaefer@rad.uni-kiel.de
Mueller-Huelsbeck
Stefan
S
Lukas
Roland
R
Schaefer
Fritz K
FK
Huemme
Tim H
TH
Heller
Martin
M
Jahnke
Thomas
T
D000328:Adult; D000368:Aged; D001012:Aorta, Abdominal; D001018:Aortic Diseases / Q000628:therapy*; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D002114:Calcinosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015641:Radiography, Interventional; D012008:Recurrence; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency