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J Chest Surg

Published online April 25, 2023

Copyright © Journal of Chest Surgery.

Comparison between Kissing Stents and Direct Surgical Bypass for Aortoiliac Occlusive Disease

Chung Won Lee, Ph.D. 1, Up Huh, Ph.D. 1, Miju Bae, Ph.D. 1, Changsung Han, M.D. 1, Hoon Kwon, M.D. 2, Gwon-min Kim, Ph.D. 3,4

Departments of 1Thoracic and Cardiovascular Surgery and 2Radiology, Pusan National University Hospital, Biomedical Research Institute, Pusan National University School of Medicine; 3Department of Medical Research Institute, Pusan National University; 4Heavy Metal Exposure Environmental Health Center, Dong-A University Hospital, Dong-A University, Busan, Korea

Correspondence to:Up Huh
Tel 82-51-240-7267
Fax 82-51-243-9389
E-mail tymfoo82@pusan.ac.kr
ORCID
https://orcid.org/0000-0002-7739-3979

This study was presented at the 54th Annual Meeting of the Korean Society for Thoracic and Cardiovascular Surgery in 2022.

Received: January 11, 2023; Revised: March 2, 2023; Accepted: March 9, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: The optimal management strategy for aortoiliac occlusive disease (AIOD) remains debatable. This study compared early and late outcomes between direct surgical bypass and kissing stents for AIOD treatment.
Methods: We retrospectively reviewed data, including age, sex, risk factors, comorbidities, symptoms, TransAtlantic Inter-Society Consensus (TASC) II classification, operation time, perioperative complications, in-hospital mortality, and length of hospital stay, from a cohort of 46 patients treated for AIOD (24 with kissing stents and 22 with direct surgical bypass) at Pusan National University Hostpital from January 2007 to December 2016. The primary, assisted primary, and secondary patency rates in both groups were compared.
Results: The hospital stay (direct surgical bypass vs. kissing stents: 16.36±5.19 days vs. 9.08±10.88 days, p=0.007) and operation time (direct surgical bypass vs. kissing stents: 316.09±141.78 minutes vs. 99.54±37.95 minutes, p<0.001) were significantly shorter for kissing stents. Kaplan-Meier analysis revealed that the primary, assisted primary, and secondary patency rates in the direct surgical bypass group were 95.5%, 95.5%, and 95.5%, respectively, at 1 year; 86.4%, 86.4%, and 95.5% at 3 years; and 77.3%, 77.3%, and 95.5% at 5 years. The primary, assisted primary, and secondary patency rates in the kissing stent group were 100.0%, 100.0%, and 100.0%, respectively, at 1 year; 95.8%, 95.8%, and 100.0% at 3 years; and 95.8%, 95.8%, and 100.0% at 5 years.
Conclusion: Except for special cases wherein endovascular revascularization is difficult, kissing stents are more advantageous for TASC II C and D lesions.

Keywords: Kissing stents, Direct surgical bypass, Aortoiliac occlusive disease

Article

ahead

J Chest Surg

Published online April 25, 2023

Copyright © Journal of Chest Surgery.

Comparison between Kissing Stents and Direct Surgical Bypass for Aortoiliac Occlusive Disease

Chung Won Lee, Ph.D. 1, Up Huh, Ph.D. 1, Miju Bae, Ph.D. 1, Changsung Han, M.D. 1, Hoon Kwon, M.D. 2, Gwon-min Kim, Ph.D. 3,4

Departments of 1Thoracic and Cardiovascular Surgery and 2Radiology, Pusan National University Hospital, Biomedical Research Institute, Pusan National University School of Medicine; 3Department of Medical Research Institute, Pusan National University; 4Heavy Metal Exposure Environmental Health Center, Dong-A University Hospital, Dong-A University, Busan, Korea

Correspondence to:Up Huh
Tel 82-51-240-7267
Fax 82-51-243-9389
E-mail tymfoo82@pusan.ac.kr
ORCID
https://orcid.org/0000-0002-7739-3979

This study was presented at the 54th Annual Meeting of the Korean Society for Thoracic and Cardiovascular Surgery in 2022.

Received: January 11, 2023; Revised: March 2, 2023; Accepted: March 9, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: The optimal management strategy for aortoiliac occlusive disease (AIOD) remains debatable. This study compared early and late outcomes between direct surgical bypass and kissing stents for AIOD treatment.
Methods: We retrospectively reviewed data, including age, sex, risk factors, comorbidities, symptoms, TransAtlantic Inter-Society Consensus (TASC) II classification, operation time, perioperative complications, in-hospital mortality, and length of hospital stay, from a cohort of 46 patients treated for AIOD (24 with kissing stents and 22 with direct surgical bypass) at Pusan National University Hostpital from January 2007 to December 2016. The primary, assisted primary, and secondary patency rates in both groups were compared.
Results: The hospital stay (direct surgical bypass vs. kissing stents: 16.36±5.19 days vs. 9.08±10.88 days, p=0.007) and operation time (direct surgical bypass vs. kissing stents: 316.09±141.78 minutes vs. 99.54±37.95 minutes, p<0.001) were significantly shorter for kissing stents. Kaplan-Meier analysis revealed that the primary, assisted primary, and secondary patency rates in the direct surgical bypass group were 95.5%, 95.5%, and 95.5%, respectively, at 1 year; 86.4%, 86.4%, and 95.5% at 3 years; and 77.3%, 77.3%, and 95.5% at 5 years. The primary, assisted primary, and secondary patency rates in the kissing stent group were 100.0%, 100.0%, and 100.0%, respectively, at 1 year; 95.8%, 95.8%, and 100.0% at 3 years; and 95.8%, 95.8%, and 100.0% at 5 years.
Conclusion: Except for special cases wherein endovascular revascularization is difficult, kissing stents are more advantageous for TASC II C and D lesions.

Keywords: Kissing stents, Direct surgical bypass, Aortoiliac occlusive disease

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