Covered balloon-expandable stents in isolated abdominal aortic stenosis or occlusion in 54 patients, predominantly women

<b></b> <i>Background:</i> Bilateral symptoms of peripheral artery disease may be rarely caused by isolated atherosclerotic aortic stenosis or short occlusion. Standard therapies have been open surgery, balloon angioplasty and implantation of selfexpanding stents and stentgrafts. <i>Materials and methods:</i> In this retrospective study 54 consecutive patients were treated under local anaesthesia with a balloon-expandable endograft. Endpoints were safety, ankle-brachial and toe-brachial index (ABI, TBI), walking distance, clinical stage and re-interventions at long-term. <i>Results:</i> There were 36 women and 18 men, mean age 68 years; 48 patients suffered from claudication, 6 patients had rest pain with skin lesions in 3 cases. The technical success rate was 100%. There was an immediate average improvement of ABI from 0.76 +/- 0.26 at rest before intervention to 0.88 +/- 0.31 at rest after stentgraft implantation into the aortic stenosis. TBI improved from 0.48 +/- 0.17 to 0.58 +/- 23 at rest. Mean follow-up was 1 to 8 years (mean 4.46) years. Average walking distance improved from 124 m to 612 m. Of the 6 patients with rest pain or skin lesions all except 1 patient improved to at least claudication stage with a painfree walking distance over 200 m. No complications such as aortic rupture, dissection or peripheral embolisation occurred, 2 patients needed surgical revision of their calcified common femoral arteries at the access sites. Three patients developed at long-term recurrent stenosis due to the compression of stentgrafts by the calcified plaque burden which was solved by balloon angioplasty or implantation of an additional aortic stentgraft. <i>Conclusions:</i> Endovascular treatment of aortic stenosis or occlusion is feasible under local anaesthesia with good functional results, very low mortality and morbidity and durable results.