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Outcomes of the single-stent versus kissing-stents technique in asymmetric complex aortoiliac bifurcation lesions

 Yongsung Suh  ;  Young-Guk Ko  ;  Dong-Ho Shin  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Donghoon Choi  ;  Myeong-Ki Hong  ;  Yangsoo Jang 
 JOURNAL OF VASCULAR SURGERY, Vol.62(1) : 68-74, 2015 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Aortic Diseases/diagnosis ; Aortic Diseases/physiopathology ; Aortic Diseases/therapy* ; Aortography ; Arterial Occlusive Diseases/diagnosis ; Arterial Occlusive Diseases/physiopathology ; Arterial Occlusive Diseases/therapy* ; Constriction, Pathologic ; Disease-Free Survival ; Endovascular Procedures/adverse effects ; Endovascular Procedures/instrumentation* ; Endovascular Procedures/methods* ; Female ; Humans ; Iliac Artery*/diagnostic imaging ; Iliac Artery*/physiopathology ; Male ; Middle Aged ; Republic of Korea ; Retrospective Studies ; Stents* ; Time Factors ; Treatment Outcome ; Vascular Patency
OBJECTIVE: This study investigated the outcomes of single-stent vs kissing-stents techniques in asymmetric complex aortoiliac bifurcation (ACAB) lesions. METHODS: We retrospectively investigated 80 consecutive patients (69 males, 66.6 ± 8.7 years) treated with a single stent and 30 patients (26 males, 67.1 ± 7.7 years) treated with kissing stents for ACAB between January 2005 and December 2012 from a single-center cohort. A ACAB lesion was defined as a symptomatic unilateral common iliac artery stenosis (>50%) combined with intermediate stenosis (30%-50%) in the contralateral common iliac artery ostium. The primary end point was the primary patency of the ACAB. RESULTS: The baseline clinical characteristics did not differ significantly between the single-stent and the kissing-stents group. Technical success was achieved in all patients. The single-stent group required fewer stents (1.3 ± 0.5 vs 2.3 ± 0.8; P < .001) and less bilateral femoral access (55% vs 100%; P < .001). Two patients in the single-stent group (3%) required bailout kissing stents because of plaque shift to the contralateral side. The major complication rates were 8% in single-stent vs 13% in the kissing-stent group, which was similar (P = .399). At 3 years, the single-stent and kissing-stents group had similar rates of primary patency (89% vs 87%; P = .916) and target lesion revascularization-free survival (93% vs 87%; P = .462). CONCLUSIONS: The single-stent technique in ACAB was safe and showed midterm outcomes comparable with those of kissing stents. Considering the benefits, such as fewer stents, less bilateral femoral access, and the availability of contralateral access for future intervention, the single-stent technique may be an advantageous treatment option in ACAB.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Shin, Dong Ho(신동호) ORCID logo https://orcid.org/0000-0002-7874-5542
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
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