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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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The Journal of Cardiovascular Surgery 2018 Feb 08

DOI: 10.23736/S0021-9509.18.10295-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Results of hybrid procedures for treatment of aortoiliac Trans-Atlantic Inter-Society Consensus II D lesions with self-expanding covered heparin-bonded stent grafts

Christian UHL , Thomas BETZ, Barbara WEISS, Ingolf TÖPEL, Markus STEINBAUER

Department of Vascular Surgery, Barmherzige Brueder Hospital, Regensburg, Germany


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INTRODUCTION: According to the guidelines aortoiliac TASC D lesions should be treated by bypass. The purpose of this study was to examine the results of hybrid procedures with the use of a self-expanding covered heparin-bonded stent graft (Viabahn) in patients with extensive aorto-iliac lesions who were not considered to be suitable for open aorto-iliac surgery.
METHODS: All patients who received a hybrid procedure in combination with a Viabahn stent in our clinic to treat aortoiliac lesions between October 2011 and April 2017 were included in this retrospective analysis. Study endpoints were primary patency, amputation free survival (AFS) and major adverse limb event (MALE) free survival after 2 years.
RESULTS: We included 23 hybrid procedures (endarterectomy of the common femoral artery or cross over bypass and aortoiliac stent) in 20 patients (median age 59 years). Indication was critical limb ischemia in 70.0%. The reasons why patients were on high risk for alternative open aortoiliac revascularization were hostile abdomen in 35.0%, cardiopulmonary contraindications in 35%, cancer in 10.0%, age > 80 years in 10.0% and alcoholic cirrhosis in 10.0%. The 30 day mortality was 15.0%, the major amputation rate was 4.3%. We had no early graft occlusion. After 2 years primary patency was 100%, AFS 58.2% and MALE free survival 95.7%.
CONCLUSIONS: A hybrid procedure with the use of a Viabahn stent in severe aortoiliac pathologies showed good patency results in this selected patient group. Therefore, it should be considered a feasible alternative to aortoiliac bypass surgery in surgical high risk patients.


KEY WORDS: Aortoiliac lesions - Peripheral arterial occlusion disease - Hybrid procedure

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Publication History

Article first published online: February 08, 2018
Manuscript accepted: January 30, 2018
Manuscript received: October 30, 2017

Cite this article as

Uhl C, Betz T, Weiss B, Töpel I, Steinbauer M. Results of hybrid procedures for treatment of aortoiliac Trans-Atlantic Inter-Society Consensus II D lesions with self-expanding covered heparin-bonded stent grafts. J Cardiovasc Surg 2018 Feb 08. DOI: 10.23736/S0021-9509.18.10295-3

Corresponding author e-mail

christian.uhl@barmherzige-regensburg.de