title: Polytetrafluoroethylene covered stent placement for focal occlusive disease of the infrarenal aorta.
abstract: BACKGROUND
  Arterial insufficiency is rarely caused by isolated infrarenal aortic occlusive lesions. Endovascular treatment options include plain balloon angioplasty and bare metal stent placement. In this study the feasibility and efficacy of polytetrafluoroethylene (PTFE) covered balloon expandable stents were evaluated.
  
  
  METHODS
  Consecutive patients from two centers were prospectively collected in a database and retrospectively analyzed. Results were evaluated by clinical examination, ankle-brachial indices (ABI), duplex ultrasound, and plain abdominal radiography.
  
  
  RESULTS
  Thirty-six consecutive patients were treated between November 2008 and June 2013. Indication for treatment was Rutherford 3 (n = 29), 4 (n = 3), and 5 (n = 4). Technical success was always achieved and there were no distal embolizations or vessel wall ruptures. The median follow-up was 22 months (range 0-60). All patients improved clinically and the ABI increased significantly from 0.73 ± 0.18 to 1.01 ± 0.14 (p < .01). One patent covered stent was removed surgically because of infection. Primary patency rates were 100% at 1 and 2 years without stent fractures.
  
  
  CONCLUSIONS
  The use of PTFE covered stents for the treatment of isolated infrarenal aortic occlusive disease is safe and very effective. Patency rates are excellent and complications including distal embolization and vessel wall rupture are extremely rare.
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: F A B
authors.initials: FA
authors.lastname: Grimme
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands. Electronic address: mmpj.reijnen@gmail.com.
authors.forename: M M P J
authors.initials: MM
authors.lastname: Reijnen
authors.affiliation: Department of Surgery, Vascular and Endovascular Surgery, University Hospital, University of Regensburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Pfister
authors.affiliation: Department of Radiology, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Martens
authors.affiliation: Department of Surgery, Vascular and Endovascular Surgery, University Hospital, University of Regensburg, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Kasprzak
mesh_terms: D001012:Aorta, Abdominal / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply*; D008297:Male; D011138:Polytetrafluoroethylene / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology*
chemical_list: D011138:Polytetrafluoroethylene
keywords: Aorta; Atherosclerosis; Covered stent; Endograft; Infrarenal; Occlusive disease