ORIGINAL ARTICLE  VASCULAR SECTION 

The Journal of Cardiovascular Surgery 2021 June;62(3):250-7

DOI: 10.23736/S0021-9509.21.11635-0

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Results of adjunctive stenting with high-radial force stents to prevent or treat limb occlusion after EVAR

Ciro FERRER ¹ ✉, Gioele SIMONTE ², Gianbattista PARLANI ², Carlo COSCARELLA ¹, Claudio SPATARO ¹, Guglielmo PUPO ², Massimo LENTI ², Rocco GIUDICE ¹

¹ Unit of Vascular and Endovascular Surgery, San Giovanni Addolorata Hospital, Rome, Italy; ² Unit of Vascular and Endovascular Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy

BACKGROUND: The aim of this study was to report the results of a multicenter experience on the use of adjunctive stents deployed inside abdominal aortic endografts with the purpose to prevent or treat limb occlusion after endovascular aneurysm repair (EVAR).
METHODS: Between 2010 and 2018, there were 35 patients with aorto-iliac aneurysm presenting one or more risk factors for endograft limb occlusion (narrow aortic bifurcation and/or stenotic, highly angulated or occluded iliac arteries), who were treated with standard bifurcated stent graft reinforced by the means of a single model of balloon-expandable platinum/iridium bare stent (CP Stent; NuMED, Inc., Hopkinton, NY, USA). Technical success, mortality, limb patency and reintervention rate during follow-up were the main endpoints assessed.
RESULTS: Technical success was 100%. No patients died perioperatively and no major complication was registered. During a mean follow-up of 48 months (range 1-87), neither aortic-related death nor secondary intervention was registered. At a mean follow-up imaging of 39.4 months (range 1-81) no endograft limb lost its patency.
CONCLUSIONS: The use of high-radial force balloon-expandable stents deployed inside bifurcated endografts to prevent or treat limb occlusion is a safe and effective adjunctive procedure, with outstanding long-term outcomes in terms of patency and reinterventions.

KEY WORDS: Aortic aneurysm, abdominal; Aneurysm; Stents; Extremities