title: Long Term Results of Kissing Stents in the Aortic Bifurcation.
abstract: BACKGROUND
  To evaluate the long-term outcome after aortoiliac kissing stent placement and to analyze variables, which potentially influence the outcome of endovascular reconstruction of the aortic bifurcation.
  
  
  METHODS
  All patients treated with aortoiliac kissing stents at our institution between April 1995 and August 2011 were retrospectively identified from a prospective single-center database. Data regarding patient characteristics (age, gender, smoking, cardio- and cerebrovascular risk factors, hyperlipidaemia, diabetes mellitus and use of antihypertensive medication), symptoms, pre-interventional examination and imaging, procedural details and follow-up were retrieved. Patency rates were calculated with Kaplan-Meier analysis. Factors affecting the patency were determined with Cox uni- and multivariate analysis.
  
  
  RESULTS
  A total of 215 patients (63% men, mean age 61 ± 10 years) were included. The median follow-up period was 31 (IQR 47.1) months. Primary, primary assisted, and secondary patency rates were 97%, 97%, and 99%, respectively, at one month; 92%, 95% and 94% at four months; 75%, 86%, and 91% at two years; 70%, 81%, and 91% at 5 years; and 67%, 81%, and 91% at ten years. Younger age and previous aortoiliac treatment were predictors for reduced primary and primary assisted patency. Smoking, previous aortoiliac intervention, TASC C and D lesions were predictors for reduced secondary patency.
  
  
  CONCLUSIONS
  Reconstruction of the aortoiliac bifurcation with kissing stents is feasible, safe and effective in all types of lesions with satisfying long term patencies. TASC C and D lesions are associated with a higher occlusion rate. Younger age and previous aortoiliac interventions are predictors for reduced primary and primary assisted patency.
authors.affiliation: Department of Vascular Surgery, Medisch Spectrum Twente Hospital, Enschede, The Netherlands; Department of Vascular Surgery, Jeroen Bosch Ziekenhuis, 's Hertogenbosch, The Netherlands.
authors.forename: J W
authors.initials: JW
authors.lastname: Hinnen
authors.forename: M A
authors.initials: MA
authors.lastname: Konickx
authors.forename: R
authors.initials: R
authors.lastname: Meerwaldt
authors.forename: J L P
authors.initials: JL
authors.lastname: Kolkert
authors.forename: J
authors.initials: J
authors.lastname: van der Palen
authors.forename: A B
authors.initials: AB
authors.lastname: Huisman
authors.forename: R H
authors.initials: RH
authors.lastname: Geelkerken
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000628:therapy*; D001157:Arterial Occlusive Diseases; D057510:Endovascular Procedures; D005260:Female; D006083:Graft Occlusion, Vascular / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency