title: Outcomes of covered expandable stents for the treatment of TASC D aorto-iliac occlusive lesions.
abstract: BACKGROUND
  Aortoiliac arterial occlusive disease is frequently encountered in the management of lower limb vascular insufficiency. We report our experience with covered balloon-expandable stents for treatment of TASC D lesions of the abdominal aorta and common iliac arteries.
  
  
  METHODS
  A retrospective study of 30 patients who underwent aortoiliac stenting with the Atrium Advanta V12 from March 2010 to September 2012 was conducted. Patient demographic data, clinical signs and symptoms and procedural details were recorded. Outcomes assessed were primary patency, secondary patency, technical success, complications, limb salvage and survival.
  
  
  RESULTS
  Median age was 67 years (range 48-84) and 40% of patients underwent treatment for critical limb ischaemia. Median follow-up was 13 months (range 3-38 months). Stent configuration comprised of long iliac stents in 20 patients, a large diameter aortic stent with iliac stenting in six patients, and aortic stent alone in four patients. Radiological success was achieved in 100% and the complication rate was 6%. Primary patency at 6, 12 and 24 months was 97%, 90% and 79%, respectively. Four cases of in-stent stenosis were reported, with three of these undergoing re-interventions resulting in a secondary patency rate of 97% at the end of follow-up. One patient death occurred within the follow-up period.
  
  
  CONCLUSIONS
  This case series demonstrates that treatment of complex aortoiliac occlusive disease with covered balloon-expandable stents can have acceptable results with good patency and good clinical outcome. Secondary patency rates are comparable to open surgical revascularisation, with lower morbidity.
authors.affiliation: Department of Vascular Surgery, Princess Alexandra Hospital, Brisbane, Australia Department of Vascular Surgery, Royal Brisbane and Women's' Hospital, Brisbane, Australia Robert.tewksbury@gmail.com.
authors.forename: Robert
authors.initials: R
authors.lastname: Tewksbury
authors.affiliation: Department of Vascular Surgery, Princess Alexandra Hospital, Brisbane, Australia.
authors.forename: Lupe
authors.initials: L
authors.lastname: Taumoepeau
authors.affiliation: Department of Vascular Surgery, Princess Alexandra Hospital, Brisbane, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Cartmill
authors.affiliation: Department of Vascular Surgery, Royal Brisbane and Women's' Hospital, Brisbane, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Butcher
authors.affiliation: Department of Vascular Surgery, Princess Alexandra Hospital, Brisbane, Australia.
authors.forename: Toby
authors.initials: T
authors.lastname: Cohen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology; D001018:Aortic Diseases / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D001027:Aortography; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: Interventional; TASC; aortic; iliac