title: Endovascular Treatment of Occlusive Lesions in the Aortic Bifurcation with Kissing Polytetrafluoroethylene-Covered Stents.
abstract: OBJECTIVE
  To determine the clinical outcomes of polytetrafluoroethylene covered balloon expandable stents (CBESs) in occlusive lesions of the aortic bifurcation in a kissing stent configuration.
  
  
  METHODS
  The study included 69 consecutive patients (29 men, 40 women) who underwent kissing stent procedures with CBESs between January 2003 and April 2009 in a single center. Patients who were previously treated with a CBES were excluded. Follow-up consisted of clinical investigation and duplex ultrasound examination.
  
  
  RESULTS
  The primary patency was 88.1% at 1 year and 71.5% at 4 years, with secondary patency rates of 88.1% and 75.3%, respectively. For patients receiving a stent for the first time, primary patency was 91.3% at 1 year and 77.1% at 4 years. For patients who had received previous stents, patency was 83.6% at 1 year and 65.2% at 4 years (P = .83). There were no differences in secondary patency and freedom from target lesion reintervention (TLR). Loss of primary patency was mainly caused by stent occlusions (14 cases [78%]). The freedom from TLR at 4 years was 76.8%.
  
  
  CONCLUSIONS
  Patency rates and freedom from TLR of CBESs in the kissing stent configuration with up to 4 years of follow-up were satisfying and mainly affected by stent occlusions. Studies focusing on optimizing stent configuration and medical care to reduce the incidence of thrombosis are indicated to improve results further.
authors.affiliation: Department of Surgery, Slingeland Hospital, Doetinchem, The Netherlands; Department of Surgery, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands.
authors.forename: Frederike A B
authors.initials: FA
authors.lastname: Grimme
authors.affiliation: Department of Radiology, Slingeland Hospital, Doetinchem, The Netherlands.
authors.forename: J Hans
authors.initials: JH
authors.lastname: Spithoven
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Clark J
authors.initials: CJ
authors.lastname: Zeebregts
authors.affiliation: Department of Surgery, Slingeland Hospital, Doetinchem, The Netherlands.
authors.forename: Dirk M
authors.initials: DM
authors.lastname: Scharn
authors.affiliation: Department of Surgery, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands. Electronic address: mmpj.reijnen@gmail.com.
authors.forename: Michel M P J
authors.initials: MM
authors.lastname: Reijnen
mesh_terms: D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000706:statistics & numerical data*; D020099:Coated Materials, Biocompatible / Q000737:chemistry; D057510:Endovascular Procedures / Q000295:instrumentation / Q000401:mortality*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011138:Polytetrafluoroethylene / Q000737:chemistry; D011859:Radiography; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D011138:Polytetrafluoroethylene