Long-term Results of Primary Stent Placement to Treat Infrarenal Aortic Stenosis

ObjectiveTo determine the safety and the long-term results of primary stent placement for localized distal aortic occlusive disease.DesignRetrospective observational study.Patients and MethodsFrom July 1998 to July 2005 17 patients (14 female and 3 men, mean age 57 years (39–80)) were treated for intermittent claudication. Five of these patients underwent additional endovascular treatment of focal iliac lesions.ResultsTechnical success defined as residual stenosis of less than 50% or a trans-stenotic systolic pressure gradient <10% was achieved in 14 of 17 (82%) patients. Major complications included dissection at the puncture site in one patient and thrombosis of additional iliac stents in another patient. Both of these complications were successfully treated. During a mean follow-up of 27 months (range 1–86), four patients had recurrence of symptoms due to in-stent restenoses (n = 2), femoral (n = 1) or iliac occlusion (n = 1), respectively. By Kaplan-Meier analysis, primary aortic hemodynamic patency was 83% at 3 years. Secondary aortic hemodynamic patency was 100%. The primary clinical patency was 68% at 3 years.ConclusionPrimary stent placement for distal aortic stenoses is an alternative to surgical treatment because of its high patency and relatively low complication rates.