Early results of stent-grafting to treat diffuse XXXX .

@entity1 @entity455 @entity101 @entity6 @entity177 @entity158 @entity1011 @entity432 @entity453
INTRODUCTION: Diffuse @entity432 or isolated @entity432 >or=10 cm long typically are treated with surgical bypass grafting because of limited durability of stent placement. We evaluated the results of stent-graft placement as an option for treatment of these diseases. METHODS: Demographic data for @entity1 undergoing stent-grafting in one or more iliac artery segments were recorded. Technical, clinical, and hemodynamic success, and aortoiliac primary and secondary patency were analyzed with Society for Vascular Surgery/American Association for Vascular Surgery criteria. RESULTS: Thirty-four consecutive @entity1 underwent stent-graft treatment because of @entity158 (65%) or tissue loss (35%). Mean @entity1 age was 63 years, and 38% of @entity1 were @entity1 . Ninety-one percent of @entity1 had @entity101 , 71% had @entity453 , 21% had @entity177 (serum @entity1011 > 2.0 mg/dL), and 26% had @entity6 ; 71% were active smokers. TransAtlantic Inter-Society Consensus C or D disease was present in 85% of @entity1 , complete common or @entity432 was present in 41%, and external iliac @entity455 requiring treatment was present in 94% of @entity1 . Mean lesion length was 13.7 +/- 8 cm. Technical, hemodynamic, and clinical success was achieved in all @entity1 in whom the lesion could be crossed with a wire. Ankle-brachial index increased from.30 +/-.03 to.59 +/-.04. Self-expanding stent grafts were used (Wallgraft, Boston Scientific, Boston, Mass, in 88% of @entity1 ; Viabahn, W. L. Gore, Flagstaff, Ariz, in 12% of @entity1 ). Concomitant common femoral endarterectomy was performed in 53% of @entity1 . At 12 months, primary patency was 70% and primary assisted patency was 88%. Four stent grafts became occluded because of distal external iliac artery or proximal common femoral @entity455 , which required subsequent common femoral endarterectomy and either external iliac artery stent grafting or extraanatomic bypass grafting. Eighty percent (four of five) of primary patency failures were in @entity1 who did not undergo concomitant common femoral endarterectomy at initial stent graft placement. CONCLUSION: Early results of stent-graft placement to treat diffuse @entity432 appear better than our recent experience with stenting alone. Concomitant common femoral endarterectomy or better assessment of femoral disease may improve durability.
