TRANSFEMORAL ENDOVASCULAR STENTED GRAFT TREATMENT OF AORTOILIAC AND FEMOROPOPLITEAL OCCLUSIVE DISEASE FOR LIMB SALVAGE

BACKGROUND: Endovascular stented grafts employ a new technique that bl ends intravascular stent and prosthetic graft technologies. These devi ces may be used to treat arterial aneurysms, occlusive disease, and va scular injuries. This report describes the application of stented graf ts to the treatment of limb-threatening ischemia secondary to occlusiv e disease of the aorta, iliae, and femoral arteries. METHODS: three pa tients with limb-threatening ischemia and severe comorbid medical illn esses were treated with transvascular stented grafts that were compose d of 6-mm thin-walled polytetrafluoroethylene grafts and Palmaz balloo n expandable stents. the grafts were inserted through a cutdown in an artery remote from the site of occlusion and introduced into the vascu lar system within 14-Fr introducer sheaths. RESULTS: Technical success was documented in all three patients with restoration of arterial con tinuity following stent graft deployment. Patency and limb salvage has been achieved to 1 year. One patient required further dilation of the proximal stent at 6 weeks. Complications were limited to an iliofemor al deep vein thrombosis in one patient. CONCLUSIONS: Endovascular sten ted grafts can be inserted to treat limb-threatening ischemia. Althoug h these initial results are encouraging, greater experience in more pa tients observed for longer periods of time is necessary before this te chnique can be advocated for widespread use.