Endovascular reconstruction of the occluded aortoiliac segment using "double-barrel" self-expanding stents and selective use of the Outback LTD catheter

J Endovasc Ther. 2011 Feb;18(1):25-31. doi: 10.1583/10-3266.1.

Abstract

Purpose: To present the early and midterm results of endovascular stent reconstruction of the occluded aortoiliac segment with selective use of the Outback LTD re-entry catheter.

Methods: Between April 2004 and February 2010, 8 patients (5 women; mean age 58.4 years, range 47-68) with occlusion of the infrarenal aorta extending to the common or external iliac arteries underwent endovascular reconstruction with double-barrel self-expanding stents. Indications for treatment were severe claudication in 6 and ulceration in 2 patients.

Results: The technical success rate was 100%, facilitated by the use of the Outback LTD catheter for accurate wire re-entry in 3 cases. There was no in-hospital mortality. One patient had a major complication (femoral artery dissection, brachial artery thrombosis, and retroperitoneal hematoma) unrelated to the re-entry device. Mean operating time was 137 minutes (range 70-253) and length of stay was 1.5 days (range 1-2). During a mean follow-up of 12.5 months (range 6-29), primary patency was 100% with no secondary interventions.

Conclusion: Total endovascular reconstruction of the occluded infrarenal aorta that extends into the iliac arteries is durable at midterm follow-up. Adjunctive use of the Outback LTD re-entry catheter can facilitate technical success.

MeSH terms

  • Aged
  • Angioplasty, Balloon / adverse effects
  • Angioplasty, Balloon / instrumentation*
  • Aortic Diseases / complications
  • Aortic Diseases / diagnostic imaging
  • Aortic Diseases / therapy*
  • Aortography / methods
  • Arterial Occlusive Diseases / complications
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / therapy*
  • Catheters*
  • Constriction, Pathologic
  • Female
  • Humans
  • Iliac Artery* / diagnostic imaging
  • Iliac Artery* / physiopathology
  • Intermittent Claudication / diagnostic imaging
  • Intermittent Claudication / etiology
  • Intermittent Claudication / therapy*
  • Male
  • Middle Aged
  • New South Wales
  • Prosthesis Design
  • Severity of Illness Index
  • Stents*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ulcer / diagnostic imaging
  • Ulcer / etiology
  • Ulcer / therapy*
  • Vascular Patency