Does Stent Overlap Influence the Patency Rate of Aortoiliac Kissing Stents?

Purpose:To determine if the position of kissing stents in the distal aorta has any influence on the patency rate. Methods:A retrospective review was conducted of 41 patients (22 men; median age 60.8 years, range 44–86) electively treated for atherosclerotic aortoiliac occlusive disease with angioplasty and kissing stents between January 1997 and January 2005. Two patient groups were defined by reviewing postinterventional anteroposterior radiograms: (1) patients in whom the proximal end of the kissing stents overlapped more than half of their angiographic width within the aorta ("crossing" group) and (2) patients in whom the proximal ends of the stents overlapped half of their width or less ("non-crossing" group). Results:At 2 years, the primary and assisted primary patency rates by life-table analysis were 60.8% and 69.4%, respectively, for the 35 patients included in the life-table analysis. There was no significant difference between the 16-patient "crossing" group and the 19-patient "non-crossing" group in terms of the baseline demographic, morphological, and procedural variables. The primary and assisted primary patency rates at 2 years for the "non-crossing" group were significantly higher (94.1% and 100%, respectively) compared to 33.2% and 45.3%, respectively, for the "crossing" group (p=0.01). Conclusions:Failure of kissing stents in the aortic bifurcation may be significantly increased by the overlap of the free proximal stent ends in the distal aorta.