Long-Term Results after Primary Stenting of Distal Aortic Stenosis

Abstract

Purpose:

To review the long-term results of primary stent placement in the distal aorta above the bifurcation.

Methods:

Fourteen patients (8 men; mean age 62 years, range 46–82) underwent primary stent implantation performed by an interdisciplinary radiosurgical team. In 10 patients, a long-term follow-up examination consisting of patient history, clinical examination, and duplex sonography was performed. The ankle-brachial index (ABI) for the posterior tibial artery was calculated on the basis of Doppler pressure measurements.

Results:

The clinical success rate at the first follow-up examination (mean 2.9 months, range 2.1–4.4) was 100% (n=14). The mean baseline ABI of 0.64±0.12 had risen to 1.02±0.10 (p<0.0001). At midterm follow-up (mean 22.8 months, range 14–42) in 12 patients, the ABI was 0.96±0.12 (p<0.0001 versus baseline). At a mean 86 months (range 51–119) after stent treatment, the ABI in 10 patients was 0.90±0.20 (p<0.0001 versus baseline). Over the long term, the clinical success rate was 70%. Deterioration was due to the progression of atherosclerosis distal to the aorta; duplex sonography showed no aortic restenosis or occlusion.

Conclusion:

In view of the excellent long-term results in our small series, primary stent placement in focal abdominal aortic stenosis in properly selected patients is a durable treatment. In addition, the mortality and morbidity risks are markedly reduced compared with open surgery.