Predictors of long-term outcomes after polytetrafluoroethylene-covered stent-graft repair of peripheral arterial aneurysms, pseudo-aneurysms, and arterio-venous fistulas

Vascular. 2020 Aug;28(4):355-359. doi: 10.1177/1708538120903960. Epub 2020 Feb 17.

Abstract

Objectives: To evaluate the primary patency rate at three years for the infra-aortic peripheral arterial pathologies treated with polytetrafluoroethylene-covered stent-grafts.

Methods: Patients treated with self-expandable polytetrafluoroethylene-covered stent-grafts for infra-aortic peripheral arterial aneurysms, pseudo-aneurysms, and arterio-venous fistulas were evaluated retrospectively. A total of 48 patients (35 male, 13 female; mean age: 53.8 ± 13.5) were included with 29.0 ± 16.5 months (median 27, range 4-70) mean follow-up period. The primary objective was to determine the primary patency rate at three years. The secondary objectives were to compare type and localization of pathology, and length and diameter of the stent-grafts with primary patency rate. Kaplan-Meier test was used as the main statistical method.

Results: Overall mean primary patency rate at three years was 77.10%. Polytetrafluoroethylene-covered stent-graft implantation in aneurysms had worse primary patency rate than pseudo-aneurysms and arterio-venous fistulas (66.6%, P = 0.03; 76.9%, P = 0.03; 88.2%, P = 0.01, respectively). Stent-graft location, length, and diameter are not associated with primary patency rate (P > 0.05) but stent diameter is associated with better primary assisted and secondary patency rates (P < 0.05).

Conclusions: Pathology of the lesion is associated with the long-term primary patency rate of polytetrafluoroethylene-covered stent-grafts but not the stent-graft location, length, or diameter. Stent diameter is associated with primary assisted and secondary patency rates.

Keywords: Arterial injuries; covered stent-graft; endovascular treatment; stent-graft.

MeSH terms

  • Adult
  • Aged
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / physiopathology
  • Aneurysm, False / surgery*
  • Arteriovenous Fistula / diagnostic imaging
  • Arteriovenous Fistula / physiopathology
  • Arteriovenous Fistula / surgery*
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Female
  • Femoral Artery / diagnostic imaging
  • Femoral Artery / physiopathology
  • Femoral Artery / surgery*
  • Humans
  • Iliac Aneurysm / diagnostic imaging
  • Iliac Aneurysm / physiopathology
  • Iliac Aneurysm / surgery*
  • Male
  • Middle Aged
  • Polytetrafluoroethylene*
  • Popliteal Artery / diagnostic imaging
  • Popliteal Artery / physiopathology
  • Popliteal Artery / surgery*
  • Prosthesis Design
  • Retrospective Studies
  • Risk Factors
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency

Substances

  • Polytetrafluoroethylene