Systematic review of results of kissing stents in the treatment of aortoiliac occlusive disease.

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Systematic review of results of kissing stents in the treatment of aortoiliac occlusive disease.

Ann Vasc Surg. 2017 Apr 05;:

Authors: Groot Jebbink E, Holewijn S, Slump CH, Lardenoije JW, Reijnen MM

Abstract
OBJECTIVES: The goal of this review is to give an overview of current results and role of the kissing stent (KS) technique in AIOD treatment.
BACKGROUND: Endovascular treatment of aortoiliac occlusive disease (AIOD) involving the aortic bifurcation is challenging. The gold standard is open surgery with patency rates up to 90% at 5 years, but has considerable morbidity and mortality. The KS technique was introduced as an alternative.
METHODS: The Cochrane guidelines were used to assure a systematic method. A search query designed in the Scopus search interface was used to identify relevant studies. Abstracts from the search were screened against the in- and exclusion criteria. During full text reading methodological quality was scored using a critical review list tailored to the topic of AIOD. Thereafter study data was extracted and pooled for further analysis.
RESULTS: 143 abstracts were retrieved using Scopus, 116 were rejected and 7 more were rejected after full text screening. One study was included after cross referencing. Twenty one studies presented 1390 patients. Rutherford classification 1/2/3 was the indication in 76.2% of patients. 48.4% of lesions were classified as TASC C or D. The technical success rate was 98.7%, the complication rate was 10.8%. Clinical improvement at 30 days was achieved in 89.9%. Primary patency at 12/24/60 months was 89.3/78.6/69.0%, respectively.
CONCLUSIONS: KS treatment of AIOD yields acceptable midterm results, with high technical success rates and mostly minor complications occur. The long-term patency cannot yet match that of open surgery, underlining the need for further research that provides insight in factors related to re-occlusion.

PMID: 28390920 [PubMed - as supplied by publisher]

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