title: Long-term results of stenting of the aortic bifurcation.
abstract: BACKGROUND
  To evaluate the long-term results in a multicentric continuous series of narrowing lesions of the aortic bifurcation treated with a kissing stent.
  
  
  METHODS
  From January, 1st 1999 to the December, 31st 2001, all of the patients (n = 80) presenting with stenosis of the aortic bifurcation (n = 15) and/or the 2 common iliac arteries (n = 65), treated with a kissing stent, in 8 teaching hospitals were collected retrospectively. The risk factors were smoking (91%), dyslipidemia (60%), arterial hypertension (42%) and diabetes (27%). In 84% of cases, the indication for treatment was claudication. The lesions were stenotic < 70% (n = 76) and/or thrombotic (n = 18). The associated lesions were external iliac stenoses (n = 21), common femoral stenoses (n = 19), femoro-popliteal stenoses (n = 42), arteriopathy in the leg (n = 35). Follow-up was clinical examination and Doppler US scan.
  
  
  RESULTS
  The success rate of the technique was 89%. There were 4 cases (5.3%) of residual stenosis and 4 cases (5.3%) of dissection. The length of the lesions treated in the aorta and the iliac arteries was respectively 17.1 ± 7 and 17.3 ± 9 mm. The stents were all placed as kissing stents, and had a mean diameter and a mean length of 13.75 mm and 56 mm in the aorta and 9 mm and 48 mm in the iliac arteries, respectively. At 5 years, 19 patients had required repeat angioplasty in the treated area, and 13 had undergone open surgery. Primary and assisted primary patency at 5 years were 64.5% and 81.8%, respectively.
  
  
  CONCLUSIONS
  Long-term follow-up of endovascular treatment with kissing stents for stenosis of the aortic bifurcation shows that this technique gives good results, though it does not justify doing away with classical revascularisation surgery, in a population with major cardiovascular risk factors.
authors.affiliation: Service de Chirurgie Cardiovasculaire, CHU Le Bocage, et Université de Bourgogne, Dijon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Abello
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kretz
authors.forename: Jean
authors.initials: J
authors.lastname: Picquet
authors.forename: Pierre-Edouard
authors.initials: PE
authors.lastname: Magnan
authors.forename: Reda
authors.initials: R
authors.lastname: Hassen-Khodja
authors.forename: Jacques
authors.initials: J
authors.lastname: Chevalier
authors.forename: Eugenio
authors.initials: E
authors.lastname: Rosset
authors.forename: Patrick
authors.initials: P
authors.lastname: Feugier
authors.forename: Maryse
authors.initials: M
authors.lastname: Fleury
authors.forename: Eric
authors.initials: E
authors.lastname: Steinmetz
mesh_terms: D001012:Aorta, Abdominal; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome