Combination of BeGraft and Solaris Stent Grafts for the Covered Endovascular Reconstruction of Aortic Bifurcation—BS-CERAB Technique

Author:

San Norberto Enrique M.1,Revilla Álvaro1,Brizuela José A.1,Del Blanco Isabel1,Flores Ángel2ORCID,Taylor James H.3

Affiliation:

1. Department of Angiology and Vascular Surgery, Valladolid University Hospital, 47003 Valladolid, Spain

2. Department of Angiology and Vascular Surgery, Toledo University Hospital, 45007 Toledo, Spain

3. Department of Angiology and Vascular Surgery, Valencia General University Hospital, 46014 Valencia, Spain

Abstract

Background: This study examines the impact of the use of the combination of BeGraft and Solaris stent grafts on the outcomes during the covered endovascular reconstruction of aortic bifurcation (BS-CERAB) technique and extension to the iliac arteries. Methods: Consecutive patients with aortoiliac occlusive disease who underwent endovascular treatment using BS-CERAB between January 2020 and December 2023 were included. Patient demographics, symptoms, lesion characteristics, and procedural and follow-up details were collected and analyzed. Perioperative complications and reinterventions were also identified. Results: A total of 42 patients met the inclusion criteria (32 men, 76.2%, median age 72 years, range 59–85). Indications for treatment were intermittent claudication (42.9%) and critical limb ischemia (57.1%). Procedure success was achieved in all cases. The median patient follow-up time was 14 months (1–36). One patient died at a 10-month follow-up due to lung cancer. The mean pre-operative ABI increased from 0.37 ± 0.19 before intervention to 0.71 ± 1.23 post-operatively at 12 months (p = 0.037). The estimated primary patency rates at 3, 6, and 12 months were 90.5%, 85.7%, and 81.0% and primary assisted patency rates were 90.5%, 90.5%, and 85.7%, respectively. Secondary patency was 95.2% at 3 and 6 months and 90.5% at a 12-month follow-up. Active cancer (p = 0.023, OR 2.12 95%CI 1.14–3.25) was a risk factor for restenosis. Conclusions: This mid-term experience shows that the CERAB technique using the combination of BeGraft and Solaris stents grafts, for the endovascular treatment of severe aortoiliac atherosclerotic disease, may allow an effective reconstruction of the aortic bifurcation and iliac arteries related to high-patency and lower-reintervention rates.

Funder

Institute of Health Sciences Studies of Castilla y León

Publisher

MDPI AG

Reference22 articles.

1. Covered endovascular reconstruction of aortic bifurcation (CEARB) technique: A new approach in treating extensive aortoiliac occlusive disease;Goverde;J. Cardiovasc. Surg.,2013

2. Geometrical consequences of kissing stents and the covered endovascular reconstruction of the aortic bifurcation in an in vitro model for endovascular reconstruction of aortic bifurcation;Grimme;J. Vasc. Surg.,2015

3. Management of extensive aorto-iliac disease: A systematic review and meta-analysis of 9319 patients;Salem;Cardiovasc. Intervent. Radiol.,2021

4. Long-term outcome following stent reconstruction of the aortic bifurcation and the role of geometric determinants;Sharafuddin;Ann. Vasc. Surg.,2008

5. Update on covered endovascular reconstruction of the aortic bifurcation;Reijnen;Vascular,2020

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