Objectives: to determine medium term technical and clinical success of kissing stents for aortoiliac occlusive disease.
Design: retrospective study.
Subjects: twenty-five patients presenting with intermittent claudication (IC) or critical limb ischaemia (CLI) due to aortoiliac disease (41 complex stenoses, 8 occlusions).
Methods: balloon- or self-expanding kissing stents, with or without predilatation depending upon the nature of the disease, were inserted via bilateral retrograde femoral artery punctures. Clinical examination, ABPI, exercise testing and duplex ultrasound were performed at 1, 3, 6, and 12 months, and then annually.
Results: technical success was achieved in 86% segments. All patients with CLI improved and 6 of 7 ulcerated limbs showed complete healing. During follow-up, 7 patients died and two patients required major amputation at 7 and 8 months. The primary assisted patency rate was 94, 91 and 65% at 6, 12, and 24 months, respectively.
Conclusions: despite acceptable short-term technical and clinical success, as the medium term patency rates are clearly inferior to those of bypass surgery, the kissing stent technique should be reserved for high risk patients with a limited life expectancy.
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http://dx.doi.org/10.1053/ejvs.2002.1882 | DOI Listing |
Am J Cardiol
December 2024
Department of Cardiovascular Medicine, Sapporo Cardiovascular Clinic, Sapporo Heart Center, Sapporo, Japan.
Limited evidence exists regarding the long-term outcomes of true versus nontrue coronary bifurcation lesions (CBLs) treated with current-generation drug-eluting stents and intravascular imaging guidance. The Sapporo Cardiovascular Clinic (SCVC) registry was a prospective, single-center, all-comers registry enrolling 1,727 consecutive patients treated with bioresorbable polymer sirolimus-eluting stent under complete imaging guidance. From this registry, 440 patients with CBLs (25.
View Article and Find Full Text PDFJ Clin Med
December 2024
1st Department of Cardiology, University of Medical Sciences, 61-848 Poznan, Poland.
The double-kissing (DK) culotte technique is a modification of the culotte technique that employs initial kissing balloon inflation after first stent implantation. The DK culotte technique may improve strut apposition and procedural outcomes; however, data on its efficacy and safety remain limited. This study aimed to investigate the short-term outcomes of bifurcation percutaneous coronary intervention (PCI) using the DK culotte technique compared with those of the culotte technique in patients with acute coronary syndrome (ACS).
View Article and Find Full Text PDFJ Surg Case Rep
December 2024
Department of Vascular Surgery, Singapore General Hospital, Academia Level, Outram Rd, Singapore.
Phlegmasia cerulea dolens is a rare manifestation of massive deep vein thrombosis with threat to limb and life. A patient with a background of ovarian malignancy in remission and pelvic radiotherapy presented with left lower limb phlegmasia cerulea dolens as a result of extensive acute left lower limb deep vein thrombosis, extending from the popliteal vein to the inferior vena cava. While initial rapid thrombolysis and left iliac vein stenting were successful, she developed significant hemorrhagic complications from her right radial intra-arterial line with compartment syndrome requiring fasciotomy.
View Article and Find Full Text PDFCVIR Endovasc
December 2024
Department of Cardiovascular Medicine, Asahi General Hospital, I-1326 Asahi, Chiba, 289-2511, Japan.
Background: Endovascular therapy is an effective method for revascularization in lower extremity artery disease, but treating chronic total occlusion (CTO) remains challenging. This is particularly true for patients with severe calcification, poor run-off in below-the-knee arteries, or limited access sites, where even guidewire (GW) passage can be difficult and bidirectional approaches are often not feasible. The tip-detection (TD) method has been reported as a useful technique in coronary artery CTO interventions, allowing real-time visualization of the GW tip direction.
View Article and Find Full Text PDFEur Heart J Qual Care Clin Outcomes
November 2024
Division of Cardiology, Cardiovascular and Thoracic Department, A.O.U Città della Salute e della Scienza, Turin, Italy.
Background: Bifurcation lesions are associated with higher rates of major adverse cardiovascular events (MACE).
Aim: To investigate the impact of imaging-guided PCI in a real-world population with coronary bifurcation lesions.
Methods: From the ULTRA-BIFURCAT registry, we compared IVUS vs.
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