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Use of the Viabahn Stent to Treat Clinically Significant Superficial Femoral Artery Occlusive Disease: A Single Practitioner’s Experience
Robert Hacker, MD, Toufic Safa, MD, FACS.
Northshore - Longisland Jewish Health System, Manhasset, NY, USA.

Objective
Viabahn covered stents have been proven to treat superficial femoral artery (SFA) occlusive disease with acceptable short and long-term patency rates and low peri-procedural morbidity. Few reports about a single surgeon or medical center experiences have been published about the clinical use of the Viabahn stent. This study retrospectively analyzes and reports the clinical findings of a single surgeon’s experience with the Viabahn stent.
Methods
A retrospective study of prospectively collected data from a single surgeon’s database was performed. Data was collected and analyzed for all endovascular procedures using the Viabahn stent between March 2008 and April 2011 (36 months). Inclusion criteria for the study were an age greater than 55 and a clinically symptomatic SFA lesion. A total of 66 limbs in 52 patients were identified and followed; their post-operative clinical outcome, stent patency rates and complications were recorded. Results were analyzed and compared to reported Viabahn stent data in the literature.
Results
A total of 66 limbs (Left SFA-33, Right SFA- 33) were treated in 52 patients (27 males, 25 females, average age 74 years) using 125 stents (average 1.89 stents/ patient). TASC II classification of SFA lesions was: A-1, B-31, C-23, and D-11. Initial technical success was 100% with a three year primary / secondary assist patency rates of 75% / 88%. Two (3.85%) patients developed non-stent related complications in the immediate post operative period. One patient developed a compartment syndrome that was successfully treated with a fasciotomy. The second patient died from a postoperative cardiac event. Seventeen (13.6 %) stent related complications were noted: 8 (6.4%) clinically significant stenoses and 9 (7.2%) thromboses. All stenoses were successfully treated with endovascular re-intervention. Two (3.03%) limbs with thrombosed stents were salvaged with a second endovascular intervention, 4 (6.06%) limbs with open bypass and 3 (4.54%) limbs required a major amputation. Complications stratified by TASC II classification are: 8 for A/B lesions and 9 for C/D lesions. No stent fractures or mid stent stenoses were identified.
Conclusions
In this study both short and long term outcomes using the Viabahn covered stent are consistent with published multi-center trials. We have demonstrated that the use of the Viabahn stent in the SFA is safe, effective and a durable therapy.


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