Value of the Hemobahn/Viabahn Endoprosthesis in the Treatment of Long Chronic Lesions of the Superficial Femoral Artery: 6 Years of Experience

Abstract

Purpose:

To evaluate the long-term efficacy of Hemobahn/Viabahn endoprostheses (HVE) in patients with femoral arterial occlusive disease.

Methods:

During a 6-year period, 57 patients (46 men; mean age 62.7±9.3 years, range 44–82) were treated with 82 Hemobahn or Viabahn endoprostheses for stenoses (13%) or occlusions (87%) of the superficial femoral artery (SFA) in 60 limbs. The average length of the treated lesions was 10.7 cm (range 3–34), and the mean length of the HVE was 15.9 cm (3–33). Patients had chronic limb ischemia in Rutherford stages 2/3 (92%), 4 (2%), and 5 (7%). The crossover method was used to deploy the stent-graft in 31 cases and the ipsilateral technique in 29.

Results:

Endoprosthesis deployment was technically successful in 59 (98%) of 60 limbs. In 2 cases, major complications (1 deployment failure and 1 thromboembolism) required additional surgery. Early thrombosis (within 30 days) occurred in 6 (10%) femoral arteries. The mean follow-up was 55 months (8–78). Late thrombosis or reocclusion was observed in 22 (37%) arteries up to 5 years after prosthesis placement (14 in the first year). Primary/secondary patency rates were 90%/95% at 30 days (n=59), 67%/81% at 1 year (n=58), 57%/80% after 3 years (n=49), and 45%/69% after 5 years (n=32). In a subgroup analysis of 48 patients with “optimal” conditions for implantation (no heavy calcifications, popliteal obstruction, or complete superficial femoral artery occlusion; minimum 1-vessel runoff; and adequate antiplatelet therapy or anticoagulation), the primary/secondary patency rates were 80%/91% after the first year (n=46), 71%/89% after 3 years (n=38), and 62%/90% after 5 years (n=21).

Conclusion:

HVE seems to be suitable for femoral arterial occlusive disease so long as ideal indications and prophylaxis against secondary thrombosis are strictly observed.