Abstract 12609: Five-Year Outcomes Following Endovascular Therapy with Stenting in the Aorto-Iliac Artery
Background: Although with the advent of stenting, endovascular therapy (EVT) has been widely used in aorto-iliac (AI) lesions, long-term outcomes and factors affecting prognosis of patients after EVT with stenting are unknown. The purpose of this study was to investigate the latter and to risk stratify patients according to prognosis predictors.
Method: Between January 2005 and December 2009, 2096 patients with AI lesions (mean age 71 years; 81% male) underwent EVT with stenting. Long-term outcomes were estimated by event-free survival (EFS) analyzed by Kaplan-Meier estimation, with event defined as any cause of death, myocardial infarction, stroke, major amputation, surgical conversion, restenosis, or target lesion revascularization. Predictors for events were determined by Cox multivariate regression analysis, and EFS rates were compared among low, moderate or high risk groups that were created based on number of predictors present.
Results: Mean follow-up duration was 2.5 years. At 5 years, EFS rates were 57.0%. By multivariable Cox regression analysis, any periprocedural complications (hazard ratio, 1.46, 95% confidence interval, 1.03-2.08; P=0.03), hemodialysis (1.48, 1.15-1.91; P=0.002), a history of heart failure (1.30, 1.01-1.68; P<0.05), reference vessel diameter (0.89, 0.82-0.97; P=0.005), outflow lesions (1.57, 1.25-1.97; P=0.0001), poor run-off (1.38, 1.03-1.86; P=0.03), and aortic bifurcation lesion (1.70, 1.26-2.3; P=0.0006) were the strong independent factors associated with event. EFS in the low-risk group (number of risk factors 0), moderate-risk group (1-2) and high-risk group (3-7) at 6 years was 73.3%, 49.3%, and 25.6%, p<0.0001, respectively.
Conclusions: Five years outcomes of patients after endovascular therapy with stenting for AI lesions were worse than expected. In particular, high-risk patients should be monitored closely after EVT.
- © 2012 by American Heart Association, Inc.