Outcomes Analysis of Surgical Conversion for Kissing-Stent Occlusion.


Journal

Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941

Informations de publication

Date de publication:
Apr 2021
Historique:
received: 29 09 2020
revised: 19 10 2020
accepted: 20 10 2020
pubmed: 19 12 2020
medline: 13 7 2021
entrez: 18 12 2020
Statut: ppublish

Résumé

We aimed to describe the operative outcomes following open aortoiliac/femoral graft reconstruction for bilateral kissing-stent (KS) occlusion. This is a bicentric, retrospective, observational cohort study. Between September 2007 and December 2019, 205 patients were treated with KS for aortoiliac reconstruction. Only those who had bilateral KS occlusion with subsequent aortoiliac/femoral graft replacement were included in this analysis. Primary outcomes were early (<30 days) and late survival, postoperative (<30 days) complications, and patency rates. Nine patients (male, n = 7) were analyzed. The patient's mean age was 60 ± 5 years (range 55-62). Median delay from initial KS procedure was 36 months (interquartile range [IQR] 19-252). On admission, all patients presented with a worse Rutherford class compared to their initial pre-KS clinical presentation. Aortobifemoral bypass was performed in 5 patients, and aortobi-iliac reconstruction in 4 patients. There were no perioperative deaths and only 1 new case of erectile dysfunction occurred. At a median follow-up time of 24 months (IQR 12-54), primary patency rate was 88.9%. Open aortic reconstruction after KS occlusion was feasible and effective. Endovascular repair for aortoiliac obstructive disease may be pursued as first-line treatment even in complex lesions.

Sections du résumé

BACKGROUND BACKGROUND
We aimed to describe the operative outcomes following open aortoiliac/femoral graft reconstruction for bilateral kissing-stent (KS) occlusion.
METHODS METHODS
This is a bicentric, retrospective, observational cohort study. Between September 2007 and December 2019, 205 patients were treated with KS for aortoiliac reconstruction. Only those who had bilateral KS occlusion with subsequent aortoiliac/femoral graft replacement were included in this analysis. Primary outcomes were early (<30 days) and late survival, postoperative (<30 days) complications, and patency rates.
RESULTS RESULTS
Nine patients (male, n = 7) were analyzed. The patient's mean age was 60 ± 5 years (range 55-62). Median delay from initial KS procedure was 36 months (interquartile range [IQR] 19-252). On admission, all patients presented with a worse Rutherford class compared to their initial pre-KS clinical presentation. Aortobifemoral bypass was performed in 5 patients, and aortobi-iliac reconstruction in 4 patients. There were no perioperative deaths and only 1 new case of erectile dysfunction occurred. At a median follow-up time of 24 months (IQR 12-54), primary patency rate was 88.9%.
CONCLUSIONS CONCLUSIONS
Open aortic reconstruction after KS occlusion was feasible and effective. Endovascular repair for aortoiliac obstructive disease may be pursued as first-line treatment even in complex lesions.

Identifiants

pubmed: 33338572
pii: S0890-5096(20)31029-3
doi: 10.1016/j.avsg.2020.10.041
pii:
doi:

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

667.e1-667.e9

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Gabriele Piffaretti (G)

Vascular Surgery, Department of Medicine and Surgery, University of Insubria School of Medicine, ASST Settelaghi Universitary Teaching Hospital, Varese, Italy. Electronic address: gabriele.piffaretti@uninsubria.it.

Raffaello Bellosta (R)

Vascular Surgery, Cardiovascular Department, Poliambulanza Foundation Hospital, Brescia, Italy.

Walter Dorigo (W)

Vascular Surgery, Department of Clinical and Experimental Medicine, University of Florence School of Medicine, Careggi University Teaching Hospital, Florence, Italy.

Maria Cristina Cervarolo (MC)

Vascular Surgery, Department of Medicine and Surgery, University of Insubria School of Medicine, ASST Settelaghi Universitary Teaching Hospital, Varese, Italy.

Matteo Tozzi (M)

Vascular Surgery, Department of Medicine and Surgery, University of Insubria School of Medicine, ASST Settelaghi Universitary Teaching Hospital, Varese, Italy.

Marco Franchin (M)

Vascular Surgery, Department of Medicine and Surgery, University of Insubria School of Medicine, ASST Settelaghi Universitary Teaching Hospital, Varese, Italy.

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