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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Aortic Surgery and Endovascular Repair Archive
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1401929

Bare metal stent application to prevent limb occlusion in severe tortuosity iliac artery during endovascular aneurysm repair (Cohort Study)

Provisionally accepted
Jiehua Qiu Jiehua Qiu 1*Xiong Zeng Xiong Zeng 2Zhinan Ju Zhinan Ju 1Xixi Min Xixi Min 1Wei Chen Wei Chen 1Kanghui Dai Kanghui Dai 1Weimin Zhou Weimin Zhou 1
  • 1 Department of vascular surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, China
  • 2 Jiangxi Provincial People's Hospital, Nanchang, Jiangxi Province, China

The final, formatted version of the article will be published soon.

    Background: The risk of limb graft occlusion (LGO) after endovascular aneurysm repair (EVAR) is increased by severe tortuosity with the iliac angle. The bare metal stent (BMS) may protect LGO, according to the hypothesis of this single-center retrospective analysis. Methods: All patients undergoing elective EVAR with a bifurcated stent graft between January 2012 - June 2022 were included in this cohort study. Patients demonstrating significant tortuosity at the iliac angle were incorporated into this study and classified into two groups: group A comprised those who received BMS. In contrast, group B consisted of those who did not receive BMS. The primary outcomes were the incidence of limb occlusion and technical success during the follow-up period. However, secondary outcomes included perioperative mortality, external iliac angioplasty, and crossed-limb techniques. Statement: The work has been reported as being in line with the STROCSS criteria27. Result: A total of 157 patients (mean age=71.6 ± 8 years) with infrarenal abdominal aortic aneurysms were enrolled. Fifty individuals were included in group A, while 107 were in group B. Overall technical success was 100%, and only one (2%) patient from group A and 17 (15%) from group B suffered from limb occlusion during follow-up (P＜0.05). At a mean follow-up imaging duration of 28.7 ±23.6 months (range 1-124), the estimated primary limb patency at 2 years was 98% for the BMS group and 84% for the non-BMS group (P<0.05). There were no changes in perioperative mortality or crossed-limb procedures between the BMS and non-BMS groups. Nonetheless, external iliac angioplasty demonstrated disparities between the two groups during the follow-up period (P<0.05). Conclusion: Using BMS deployed inside the iliac artery to prevent or treat limb occlusion is a safe and effective strategy, with obvious prolonged outcomes concerning patency and re-interventions.

    Keywords: Abdominal Aortic Aneurysm, Limb graft occlusion, Endovascular aortic aneurysm repair, Bare metal stent, Interventional therapy

    Received: 16 Mar 2024; Accepted: 31 Oct 2024.

    Copyright: © 2024 Qiu, Zeng, Ju, Min, Chen, Dai and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jiehua Qiu, Department of vascular surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, China

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