Efficacy of Viabahn® in the treatment of severe superficial femoral artery lesions:: Which factors influence long-term patency?

Purpose. To evaluate superficial femoral artery (SFA) occlusive disease treatment by means of covered stents. Study design. retrospective. Method. From 2000 to 2005, a HemobahnIViabahn(R) endoprosthesis was implanted in 102 limbs (95 patients; mean age: 72.1 years, 52-94) for intermittent claudication (group I, n = 50 limbs), critical (group II, n = 32) or acute ischemia (group III, n = 20). Lesions treated were Trans-Atlantic Inter-Society Consensus (TASC) A (n = 9) B (n = 42), C (n = 28) or D (n = 23), associated with a good (2 or 3 leg arteries, n = 60) or a poor (1 or 0 artery, n = 42) runoff. Results. The endograft was placed successfully in all cases, but 3 early deaths (3.2%) (1 in group II and 2 in group III), and 4 acute thromboses (4%) occurred. Primary and secondary actuarial patency rates were 97 +/- 1.7%, and 99 +/- 1% at 1 month, 74 +/- 4.8% & 84 +/- 4.1% at I yearand 71 +/- 9.5% & 79 +/- 8.5% at 3 years, after a mean follow-up of 30.2 months (1-60). Long-term primary and secondary patencies were significantly different between TASC Cand TASC D lesions (P < .004 & .001). Conclusion. Severity of lesions, rather than preoperative symptoms or runoff, is mainly to be considered before using HemobahnIViabahn(R) endoprosthesis in severe SFA occlusive lesions. (C) 2007 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.