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Kissing-stent technique effective in aortoiliac occlusive disease
According to a patient-level meta-analysis, the kissing-stent technique was safe and maintained acceptable patency rates at 2 years in patients with aortoiliac occlusive disease.
The researchers analyzed deidentified patient-level data from five trials covering 605 patients (mean age, 61 years; 56% men) with aortoiliac occlusive disease who were treated with the kissing-stent technique.
Among the cohort, 15.8% had critical limb ischemia and the rest had intermittent claudication. There were TransAtlantic Inter-Society Consensus (TASC) A and B lesions in 52.8% of patients, whereas the rest had TASC C and D lesions, which are more complicated.
At 2 years, the overall primary patency estimate was 81%, Erik Groot Jebbink, PhD, from Rijnstate Hospital in Arnhem and Technical Medical Centre, University of Twente, both in the Netherlands, and colleagues wrote.
Half the cohort had their procedures done before 2005 and the other half after. The group with procedures performed after 2005 had better patency rates (P = .005), according to the researchers.
The only independent predictor of sustained primary patency was age (HR = 0.6; P < .005), whereas history of CVD was the main independent predictor of secondary patency (HR = 0.27; P = .04), and previous endovascular intervention was the main predictor of loss of secondary patency (HR = 2.52; P = .02), Jebbink and colleagues wrote.
“Younger (< 50 years) patients might have a more ‘aggressive’ type of atherosclerosis, becoming symptomatic at an earlier age and being more prone to disease progression after treatment and subsequent patency loss. Therefore, the endovascular-first decision might be less obvious in young patients,” they wrote.
Primary patency rates were better in TASC C and D lesions than in TASC A and B lesions at 24 months (P = .047), according to the researchers. – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.