Endovascular abdominal aortic stenosis treatment with the OptiMed self-expandable nitinol stent

To evaluate the safety and feasibility of self-expandable stents (OptiMed) for treatment of abdominal aortic stenosis in the situations in which the aortic stenosis locates near the origin of celiac, superior mesenteric, renal and inferior mesenteric arteries.

Five consecutive patients scheduled for endovascular treatment of abdominal aortic stenosis by self-expandable nitinol stent (Sinus-Aorta/OptiMed) implantation. The diameter of the stent was chosen as 10-30% more than that of the normal portion of the aorta above the stenosis. Long stents of 60 mm or longer were chosen. After stent deployment, balloon postdilation was performed with a balloon in patients with residual gradient > 5 mm Hg.

All patients were successfully treated with the OptiMed stents. The balloon predilation was performed in one patient due to severe stenosis. The mean diameter and length of the stents deployed were 20.4 +/- 2.9 (range, 16-24 mm) and 64 +/- 8.9 (range, 60-80 mm), respectively. The balloon postdilation was performed in all cases. The mean diameter of the balloons was 13.6 +/- 1.5 (range, 12-15 mm). The mean diameter of stenosis increased from 4.8 +/- 1.9 to 14.4 +/- 1.8 mm after stent placement. The mean peak systolic gradient decreased from 46.8 +/- 31.5 mm Hg to 0.8 +/- 1.8 mm Hg. During follow-up (22.8 +/- 14.3 months), none of the patients had restenosis within the stent, occlusion of any branches of the aorta, or other related complications.

In our small series, we observed that abdominal aortic stenosis can be successfully and effectively treated with OptiMed stents in the situations in which the stenotic segment is located next to the origins of the main visceral branches of abdominal aorta.