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Contemporary Outcomes After Endovascular Treatment for Aorto-Iliac Artery Disease

2012; Japanese Circulation Society; Volume: 76; Issue: 11 Linguagem: Inglês

10.1253/circj.cj-12-0492

1347-4820

Yoshimitsu Soga, Osamu Iida, Daizo Kawasaki, Yasutaka Yamauchi, Kenji Suzuki, Keisuke Hirano, Ryoji Koshida, Daisuke Kamoi, Junichi Tazaki, Michiaki Higashitani, Yoshiaki Shintani, Terutoshi Yamaoka, Shinya Okazaki, Nobuhiro Suematsu, Taketsugu Tsuchiya, Yusuke Miyashita, Norihiko Shinozaki, Hiroki Takahashi, on behalf of REAL-AI investigators,

Vascular Procedures and Complications

Background: The patency and complications in aorto-iliac (AI) stenting remain poorly understood. The aim of this paper was to investigate the safety and efficacy after AI stenting. Methods and Results: This study was performed as a large-scale multicenter, retrospective registry. A total of 2,147 consecutive patients with AI disease were enrolled. The safety endpoints were procedure success, complications and 30-day mortality. The efficacy endpoints were primary, assisted primary and secondary patency, overall survival, freedom from major adverse cardiovascular events (MACE; all-cause death, myocardial infarction and stroke), and major adverse cardiovascular and limb events (MACLE; any repeat revascularization for limb and leg amputation in addition to MACE). Procedure success, complication rate and 30-day mortality were 97.6%, 6.4% and 0.7%. Primary patency was 92.5%, 82.6% and 77.5% at 1, 3 and 5 years, assisted primary patency was 97.0%, 92.7% and 91.9% at 1, 3 and 5 years and secondary patency was 99.0%, 98.7% and 98.5% at 1, 3 and 5 years. The overall survival rate was 95.0%, 87.6%, and 79.3% at 1, 3 and 5 years. The cause of death was cardiovascular in 44.1%. Freedom from MACE (MACLE) was 93.3% (89.9%), 84.4% (76.7%), and 74.9% (66.8%) at 1, 3 and 5 years. Female gender, diabetes, renal failure, absence of aspirin, reference vessel diameter <8.0mm and outflow lesion were found to be independent predictors of primary patency. Conclusions: The safety and efficacy after AI stenting are feasible compared to surgical reconstruction. (Circ J 2012; 76: 2697–2704)