Safety and Efficacy of Stent-Graft in the Treatment of Aortoiliac Artery Occlusive Disease: A Multicenter Study of Short-Term and Medium-Term Outcomes

Ann Vasc Surg. 2024 Jun:103:31-37. doi: 10.1016/j.avsg.2023.11.032. Epub 2024 Jan 30.

Abstract

Background: To evaluate the short-term and mid-term safety and efficacy of stent-graft compared with bare stents for treatment of aortoiliac occlusive disease (AIOD).

Methods: One hundred eighty three patients diagnosed with AIOD who received stent implantation at 3 vascular centers in north China between January 2019 and December 2021 were enrolled. Patients were divided into those undergoing stent-graft (Group A; n = 67) or bare stent (Group B; n = 116) implantation for retrospective cohort analysis. Efficacy was assessed as surgical success rate and rate of freedom from clinically driven target lesion reintervention at each follow-up time point. Safety was assessed by the rate of perioperative complication, major limb amputation, and aortoiliac artery-related mortality.

Results: There were no preoperative baseline differences between the 2 groups (P > 0.05). The surgical success was 91.04% for Group A, significantly higher than that for Group B (79.31%; P < 0.05). Incidence of perioperative complications was 2.98% for Group A, significantly lower than that for Group B (9.48%, P < 0.05), as was the rate of major limb amputation (A: 1.49% vs. B: 5.17%) and aortoiliac artery-related mortality (A: 1.49% vs. B: 4.31%), although these 2 indicators were not significantly different (P > 0.05). Follow-up rates were 91.8% for the total follow-up time of 3 years. Kaplan-Meier survival curve analysis gave significantly higher 1-year and 2-year freedom from clinically driven target lesion reintervention for Group A (98.51% and 95.52%) than for Group B (95.69% and 89.66%, P < 0.05).

Conclusions: Stent-graft is more effective and safer than bare stent in the treatment of AIOD.

Publication types

  • Multicenter Study
  • Comparative Study

MeSH terms

  • Aged
  • Amputation, Surgical*
  • Aortic Diseases* / diagnostic imaging
  • Aortic Diseases* / mortality
  • Aortic Diseases* / surgery
  • Arterial Occlusive Diseases* / diagnostic imaging
  • Arterial Occlusive Diseases* / mortality
  • Arterial Occlusive Diseases* / surgery
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Blood Vessel Prosthesis Implantation* / mortality
  • Blood Vessel Prosthesis*
  • China
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / instrumentation
  • Endovascular Procedures* / mortality
  • Female
  • Humans
  • Iliac Artery* / diagnostic imaging
  • Iliac Artery* / surgery
  • Limb Salvage
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Prosthesis Design
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency*