Covered stents versus bare-metal stents in kissing reconstructions of the aortic bifurcation

BACKGROUND: Although endovascular revascularization is the preferred treatment in aortoiliac occlusive disease (AIOD), few studies have compared covered stents (CS) versus bare-metal stents (BMS) in this location. The aim of our multicenter study was to compare CS and BMS result in kissing reconstruction of the aortic bifurcation.METHODS: We considered all patients who had kissing stent for AIOD between February 2015 and March 2020, in three European centers. Data were collected retrospectively and CS and BMS groups were compared.RESULTS: A total of 124 patients were included (66.1% males; mean age 67.8±0.9 years), 79 in the CS group and 45 in the BMS group. The two groups were similar in terms of age, comorbidities and TASC II classification. The mean follow-up was 22.58±1.6 months and was similar in the two groups (P=0.138). Technical success was 100%; primary patency at 24 months was 94.3% for CS and 81.2% for BMS (P=0.168). Assisted primary patency was better in the CS group (P=0.054). There were no statistically significant differences in restenosis and thrombosis rates, secondary patency, limb salvage, and survival. When comparing the TASC C-D and TASC A-B groups, survival was statistically significant (P=0.03) in favor of the TASC A-B group.CONCLUSIONS: The kissing stent technique ensure excellent results in terms of technical success and patency in the short and medium term. No statistically significant differences between the two types of stents emerged in our population, even if the use of CS seems to provide slightly better results than BMS.