Biomedical subjects

G Biamino

Publications and source records attributed to G Biamino.

At least 19 recordsLinked to original sources

PubMed2004

Endoluminal stent-graft placement for acute rupture of the descending thoracic aorta.

AIMS: To investigate the results of endovascular stent-graft placement for the treatment of acute perforating lesions of the descending thoracic aorta. METHODS AND RESULTS: A total of 31 consecutive patients underwent interventional treatment for perforating lesions of the descending aorta. In 21 cases (group A), the aortic perforation was due to rupture of a descending thoracic aneurysm or dissection, whereas 10 patients (group B) were treated for traumatic transection of the descending aorta. A total of 42 endoprostheses were implanted. The implantation procedure was successful in all cases without peri-interventional complications. In one case, implantation of a second endoprosthesis became necessary due to type I endoleak. Overall, the 30-day mortality was 9.7%. As all three deaths occurred in group A, the mortality rate in this group was 14.3% versus 0% in group B. Similarly, postinterventional complications were more prevalent, with 28.6% in group A (renal failure n = 4; stroke n = 2) versus 10.0% in group B (renal failure n = 1). No paraplegia and no further deaths or ruptures occurred during follow-up (mean 17 months). CONCLUSION: Interventional stent-graft placement is an effective treatment option for the emergency repair of descending aortic perforations.

Acute Kidney Injury↗

PubMed2004

First clinical experiences with an endovascular clamping system for neuroprotection during carotid stenting.

OBJECTIVES: This report evaluates the feasibility and efficacy of an endovascular blood flow blockage technique to prevent intracerebral embolization of plaque debris during carotid artery stenting. METHODS: Forty-two patients were enrolled in five clinical sites in Germany and Italy with either an asymptomatic internal carotid artery stenosis > or =75% (mean 87%) or a symptomatic stenosis > or =60% (mean 85%). Cerebral protection during the stenting procedure was achieved using an endovascular clamping technique, obtained by occlusion of the external and common carotid artery via two independently inflatable balloons integrated in the Mo.Ma system. Blood with particulate plaque debris was aspirated before flow was restored. The patient's clinical and the neurological status were assessed during intervention, at discharge, and at 3 months follow-up. RESULTS: Stenting was performed in all but one patient. The mean flow occlusion time was 10.6+/-6.5 min. Transient clamping intolerance was observed in five patients (12%). In two patients, neurological deficits persisted for 2 and 12 h, respectively. Two minor strokes (4,7%) occurred at 5 and 72 h after the procedure. No major strokes or deaths were observed at 3 months follow-up. CONCLUSIONS: This first clinical experience with the Mo.Ma device substantiates the feasibility of endovascular clamping in preventing cerebral embolization during carotid artery stenting.

Carotid Artery, Internal↗

PubMed2004

Excimer laser assisted angioplasty for the treatment of critical limb ischemia.

Two decades after the clinical introduction of percutaneous transluminal angioplasty (PTA), controversy still exists about the role of PTA for the treatment of occlusive disease in the femoropopliteal and infragenicular arteries. For the patient with critical limb ischemia (CLI), where diffuse disease and long occlusions are the rule, the results with PTA have not been optimal. Surgical revascularization has long been considered the gold standard for this patient population, but this procedure is associated with significant morbidity and mortality and up to 37% of patients may be poor surgical candidates. With advances in laser catheter design and refinement of recanalization techniques, improved results have been seen with laser assisted angioplasty of complex peripheral arterial disease. There has been renewed interest in excimer laser angioplasty for the treatment of patients with long total occlusions and diffuse disease who otherwise would have limited options for treatment. Excimer laser assisted angioplasty has been shown to be a successful approach to the treatment of long occlusions in the superficial femoral artery. Data from the recently completed Laser Angioplasty for Critical Limb Ischemia Phase 2 Trial (LACI) suggest that this is a viable treatment strategy for patients with CLI who are otherwise not good candidates for bypass surgery.

Aged↗

PubMed2003

[Intra-arterial lysis therapy in acute limb ischemia. Technical possibilities and limits of indication].

Acute limb ischemia is associated with a high risk of death and loss of the extremity. To restore the blood flow, several percutaneous thrombolytic techniques were developed. To achieve a targeted thrombus infiltration, the continuous application of low-dose urokinase or recombinant tissue plasminogen activator using a specific lysis catheter with sideholes is preferable. Concerning the amputation-free survival, thrombolysis is superior to surgery for occlusions of native vessels or bypass grafts that are not older than 2 weeks. Furthermore, the percutaneous approach permits the simultaneous treatment of the underlying lesion by angioplasty or stent implantation after dissolution of the occluding thrombus. The higher risk of complications must be balanced against risks of surgery in each patient.

Acute Disease↗

PubMed2002

Results of a European multicentre iliac stent trial with a flexible balloon expandable stent.

PURPOSE: to determine the 12 months success rate with a balloon expandable, flexible stainless steel stent in iliac artery obstructions. MATERIALS AND METHODS: one-hundred and twenty-six consecutive patients with iliac obstructive disease and who demonstrated an unsatisfactory angioplasty result with a post-dilatation gradient of at least 10 mmHg, or a primary occluded lesion were included in the study. Follow-up was by Doppler sonography, ankle pressures with and without exercise and clinical parameters. RESULTS: after stent placement, the mean percentage diameter stenosis decreased from 79 to 4%, with a mean intra-arterial pressure gradient of 3 mmHg. Primary stent patency was 94% at 6 months and 89% at 12 months. Primary clinical result at 6 months was 88% and at 12 months 81%. Primary assisted clinical result (after re-pta) at 6 and 12 months was 89 and 86%, respectively. The Ankle Brachial Index (ABI) after exercise at 1 month follow-up was reduced from 0.88 to 0.75, with minor deterioration at 6 months to 0.72, and at 12 months to 0.68. The 1, 6, and 12 months follow-up Piek Systolic Velocity (PSV) ratios across the stented lesions remained stable at a mean of 1.4, 1.6, and 1.6, respectively. However, respectively 44, 39 and 34% of the patients still experienced symptoms of claudication. CONCLUSIONS: the results presented here support the suggestion stenting to be an effective device in the treatment of iliac artery obstructive disease. This study also, confirms other study results concerning haemodynamic patency after iliac stenting on the indication of a 10 mmHg pressure gradient after pta and the discrepancy between good haemodynamic patency and clinical result.

Adult↗

PubMed2001

Stent-supported recanalization of chronic iliac artery occlusions.

PURPOSE: Iliac artery occlusions that are more than a few centimeters in length are normally treated with surgical bypass grafting. The aim of this study was to evaluate the results of primary stent implantation after Excimer laser-assisted recanalization of iliac artery occlusions. SUBJECTS AND METHODS: We studied 212 consecutive patients with chronic unilateral iliac artery occlusions (mean [+/- SD] length 8.9 +/- 3.9 cm) who were treated with Excimer laser-assisted recanalization and stent implantation. Based on the criteria of the Society of Cardiovascular and Interventional Radiology, lesions were graded as class III occlusions (<5 cm) in 46 patients and as class IV (> or =5 cm) in 166 patients. A total of 527 stents (Palmaz stent, 346; Wallstent, 94; Strecker stent, 38; covered stents, 49) were implanted. RESULTS: Technical success was achieved in 190 (90%) patients. There was a clinical improvement of three grades in 112 (53%) patients and of two grades in 67 (32%) patients. The rate of major complications was 1.4%, which included arterial rupture (1) and embolic events (2). Primary patency rates were 84% at 1 year, 81% at 2 years, 78% at 3 years, and 76% at 4 years. Secondary patency rates were 88% at 1 year, 88% at 2 years, 86% at 3 years, and 85% at 4 years. CONCLUSION: Stent-supported angioplasty is an effective treatment for iliac artery occlusions, with less morbidity and mortality than is associated with surgery. However, reported long-term patency rates after bypass surgery are greater than those we observed with interventional treatment. The value of primary stenting as compared with angioplasty alone should be evaluated in a randomized trial.

Arterial Occlusive Diseases↗

PubMed2001

[Percutaneous revascularization of long-standing chronic occlusion of the superficial femoral artery. A pilot study].

BACKGROUND AND OBJECTIVE: The treatment of long chronic occlusion of peripheral arteries remains unsatisfactory. In particular occlusions of the superficial femoral artery (SFA) are not considered suitable for percutaneous interventions. It was the aim of our study to evaluate this technique, the initial technical success and the follow-up patency rates after percutaneous revascularization of long chronic occlusion of the the SFA. PATIENTS AND METHODS: 58 consecutive patients (mean age 64.8 +/- 9.7/40-80 years, 40 men/69.0%) were included. Of these patients 15 had bilateral SFA-occlusions and 14 showed additional disease in the popliteal artery. The mean occlusion length was 21.9 +/- 14.8 cm. At baseline absolute treadmill walking distance was 125 +/- 61 m. in all cases a balloon angioplasty was performed, additional excimer laser in 80.8% and stenting in 50.9%. RESULTS: A primary technical success was achieved in 89.0%. According to the American Heart Association guidelines a markedly clinical improvement was shown: +3 in 16.2%, +2 in 74.4%, +1 in 9.3% of the patients. The 12-months cumulative primary patency rate was 43.6%, primary assisted patency and secondary patency rate was 85.5% and 69.1% respectively. CONCLUSION: Long chronic occlusion can be successfully treated by percutaneous techniques. To maintain a high patency rate frequent clinical follow-up is mandatory.

Adult↗

PubMed2001

Postinterventional transcutaneous suture of femoral artery access sites in patients with peripheral arterial occlusive disease: a study of 930 patients.

The purpose of this study was to evaluate a percutaneous vascular suture (PVS) device in patients with peripheral arterial occlusive disease (PAOD) for achievement of immediate hemostasis at the vascular access site and early ambulation of fully anticoagulated patients after peripheral interventional procedures. From June 1995 to March 2000, a vascular suture using a PVS device (6-10 Fr) was applied in 930 patients with PAOD. All patients had received an endoluminal intervention in the pelvic and/or the contralateral femoropopliteal region via a retrograde access through the common femoral artery (CFA). The incidence of complications within 12 hr after intervention, prior to discharge, and at 30-day follow-up was assessed employing clinical examination, treadmill test, and color Doppler ultrasound and the safety of the PVS device was determined. The efficacy of the system was measured by the percentage of achieved immediate hemostasis and early ambulation. PVS was technically successful in 92.2% independently from the degree of calcification at the access site. In 7.8%, an appropriate suture delivery could not be performed and these patients were successfully treated by conventional compression technique. Device malfunction or insufficient suture closure occurred in 1.7% and 2.1%, respectively. In 7.0%, groin-related complications occurred. Ambulation within 2-4 hr after successful suture was possible in 96.1%. All patients were free of any local symptoms at 30-day follow-up. The PVS device provides a safe and effective solution to achieve immediate hemostasis, thus permitting early ambulation in fully anticoagulated patients with PAOD after peripheral interventional procedures.

Arterial Occlusive Diseases↗

PubMed2001

Transradial approach for renal artery stenting.

Percutaneous interventional procedures in the renal arteries are usually performed using a femoral or brachial vascular access. The transradial approach, which has been extensively investigated for coronary angiography and intervention, could be an attractive new technique for renal artery angioplasty and stenting. In 18 patients with hemodynamically relevant unilateral renal artery stenosis (mean diameter stenosis, 83% +/- 18%; right, n = 7; left, n = 11), interventional treatment with PTA and stenting was performed using a left (n = 16) or right (n = 2) radial artery access. Indications for the transradial approach were acute aorto-renal angles or severe peripheral arterial obstructions. After engagement of the renal artery ostium with a 6 Fr Multipurpose guiding catheter (length, 125 cm; Cordis) the stenosis was passed with a 0.014" guidewire followed by stent implantation (ACS Multi-Link RX Ultra, Guidant; length, 18 mm; diameter, 5 mm). Direct stenting was successfully performed in 16 cases. Predilatations were required in two cases. In five patients, optimal stent expansion was achieved by additional postdilatations. A primary technical success (residual stenosis < 30%) could be achieved in all cases. There were no periprocedural complications. According to color-coded doppler ultrasound, all access site arteries showed a normal perfusion. Clinically blood pressure control was improved in 11 patients with a significant reduction in systolic and diastolic blood pressure values. Serum creatinine values dropped from 1.81 +/- 0.3 mg/dl to 1.49 +/- 0.3 mg/dl (P < 0.001). Transradial renal artery angioplasty and stenting is technically feasible and safe. Particularly in patients with unfavorable vessel anatomy, this new cranio-caudal approach is an attractive alternative technique.

Aged↗

PubMed2001

[Treatment of peripheral arterial thromboembolic occlusions using a new percutaneous mechanical thrombectomy system].

PURPOSE: We report our experience with a new percutaneous thrombectomy device for the treatment of thromboembolic occlusions of peripheral arteries. MATERIAL AND METHODS: Between November 1999 and May 2000 12 patients (10 male) with thromboembolic occlusions of peripheral arteries were treated. 8 occlusions were located in the femoral and popliteal arteries, 3 in the infrapopliteal vessels and 1 in the brachial artery. In all cases a new 6 F-catheter with a rotational screw and a suction vacuum unit was used. RESULTS: The intervention was successful in 11 patients. 1 patient with a failed procedure had a duration of occlusion > 90 days. There were no complications. All patients were discharged on the same or the following day. CONCLUSION: Percutaneous treatment with the thrombectomy device is a feasible option in a small group of patients with thromboembolic occlusions of the peripheral arteries. Often additional treatment is necessary. The major indication seems to be acute thrombosis. The procedure is easy and safe to apply.

Aged↗

PubMed2001

Excimer laser-assisted recanalization of long, chronic superficial femoral artery occlusions.

PURPOSE: To examine the safety and efficacy of excimer laser-assisted angioplasty (ELA) for recanalization of superficial femoral artery (SFA) occlusions. METHODS: Data were analyzed from 318 consecutive patients (207 men; mean age 64.2 +/- 10.7 years, range 33-91) who underwent ELA of 411 SFAs with chronic occlusions averaging 19.4 +/- 6.0 cm in length. More than 75% of patients had severe claudication (category 3). Critical lower limb ischemia with rest pain or minor tissue loss was present in 6 and 15 patients, respectively. The mean ankle brachial index (ABI) before and after exercise was 0.62 +/- 0.15 and 0.40 +/- 0.18, respectively. RESULTS: The initial attempt (crossover approach 89.7%, antegrade 6.6%, transpopliteal 3.6%) to cross the occlusion with an excimer laser catheter was successful in 342 (83.2%) of 411 limbs. A secondary attempt performed in 44 of 69 failed cases was successful in 30 limbs, increasing the technical success rate to 90.5% (372/411). Complications included acute reocclusion (4, 1.0%), perforation (9, 2.2%), and distal thrombosis/embolization (16, 3.9%). Postprocedurally, 219 (68.8%) patients were asymptomatic; mild (category 1) or moderate (category 2) claudication remained in 53 (16.6%) and 26 (8.2%) patients, respectively. The primary patency at 1 year was 33.6%. In the majority of patients, reocclusion was treatable on an outpatient basis. The 1-year assisted primary and secondary patency rates were 65.1% and 75.9%, respectively. CONCLUSIONS: Long SFA occlusions can be recanalized safely and successfully by ELA. However, to maintain patency and quality of life, intensive surveillance using objective testing followed by prompt repeat intervention are mandatory.

Adult↗

PubMed2001

Pseudoaneurysm formation at the site of external iliac artery stents: percutaneous stent-graft treatment.

PURPOSE: To present a patient who developed an asymptomatic large iliac pseudoaneurysm complicating stent-supported iliac artery recanalization. CASE REPORT: The pseudoaneurysm was detected in an asymptomatic 69-year-old man during routine angiography 6 months after an uncomplicated procedure to implant 3 overlapping Palmaz stents in an occluded external iliac artery. There was no evidence of stent infection. During a second intervention, the pseudoaneurysm was successfully treated by percutaneous implantation of an EndoPro System I stent-graft. Contrast-enhanced spiral computed tomography at 6 and 12 months confirmed the durability of aneurysm exclusion and the patency of the endoprosthesis. CONCLUSIONS: Angioplasty-induced pseudoaneurysm is rare and usually asymptomatic, but elective percutaneous stent-graft repair should be considered as the first treatment option.

Aged↗

PubMed2000

Treatment of iliac artery aneurysms by percutaneous implantation of stent grafts.

BACKGROUND: Iliac artery aneurysms have traditionally been treated by direct surgical reconstruction. Endovascular stent grafts have been developed to provide an effective but less invasive treatment option for patients with peripheral arterial aneurysms. METHODS AND RESULTS: In 48 patients, a total of 53 endoprostheses (mean length 7. 3 cm, mean diameter 8.1 mm) were implanted into the iliac arteries (common iliac artery n=29, external iliac artery n=19) for percutaneous exclusion of aneurysmal lesions. The technical success of complete exclusion of the aneurysm was achieved in 47 of 48 cases (97.9%). In 1 case, persistent perfusion through a collateral branch was detected; however, this aneurysm thrombosed spontaneously within 2 weeks. In all patients, graft patency was monitored by clinical examination, which included the standardized treadmill test with calculation of the ankle-brachial Doppler index and color-coded duplex ultrasound. Forty-two of the 48 patients (87.5%) underwent follow-up angiography. According to Kaplan-Meier life-table calculations, primary patency rates were 100% after 1 year, 97.9% after 2 years, 94.9% after 3 years, and 87.6% after 4 years. Serial contrast-enhanced spiral CT scans were performed to rule out late procedural failures and to assess growth progression of the lesions. No secondary leaks were observed. Furthermore, the aneurysm diameter had reduced from 24.8+/-8.0 mm to 23.1+/-6.6 mm at the last follow-up (P:=NS). CONCLUSIONS: Stent grafts are a safe and effective treatment option for iliac artery aneurysms and provide good long-term patency of the graft.

Aged↗

PubMed2000

[Percutaneous reconstruction of a pelvic vascular occlusion using the "kissing-balloon" technique].

UNLABELLED: A 43-year-old patient was admitted for severe claudication in his right leg, doppler ultrasound and angiography revealed an occluded right common iliac artery. Using the cross-over-approach from the contralateral side, it was possible to navigate a guide wire through the occlusion, and after passage with an excimer laser an ipsilateral retrograde puncture with placement of a sheath was performed. In order to protect the the aortoiliac bifurcation, a primary stent implantation of the occluded side was carried out using the kissing balloon technique. Afterwards three stents were placed. Subsequently the patient completely improved; treadmill exercise test and duplex sonography showed good results. CONCLUSION: Using the kissing balloon technique, laser-assisted recanalisation of iliac artery occlusions even involving the aortoiliac bifurcation compare favorable to other more invasive treatments. A surgical procedure can thus be avoided.

Adult↗

PubMed2000

Treatment of catheter-induced iliac artery injuries with self-expanding endografts.

PURPOSE: To evaluate the efficacy of fabric-covered endoprostheses for percutaneous repair of traumatic iliac artery lesions. METHODS: Among 47 patients treated for catheter-induced iliac artery injuries, 20 (42%) patients (13 men; mean age 58 +/- 10 years, range 41-76) presented with acute (n = 7) or subacute (n = 13) lesions considered inappropriate for bare stent implantation (17 dissecting aneurysms, 2 perforations, and 1 traumatic arteriovenous fistula). The self-expanding Cragg EndoPro System I or Passager devices were deployed percutaneously to exclude the defects. RESULTS: Immediate exclusion of the lesion was achieved in all 20 cases; there were no major procedural complications. However, within 24 hours after implantation, fever (n = 11, 55%) and elevations in white blood cell count (n = 10, 50%) and C-reactive protein (n = 13, 65%) were seen in the majority of patients, which prolonged hospitalization in this group (8.4 versus 4.2 days). During a median 21-month follow-up (range 5-31), 2 angiographically documented restenoses at the outlet of the endografts were treated successfully with balloon angioplasty, achieving primary and secondary patency rates of 87% and 100%, respectively. CONCLUSIONS: Early model stent-grafts provided a safe and effective endovascular treatment for iliac perforations and large arterial dissections, showing a high mid-term patency rate. However, postimplantation syndrome appears to occur frequently with this type of Dacron-covered nitinol device.

Adult↗

PubMed2000

[Percutaneous therapy of catheter-induced traumatic vascular lesions with Dacron coated nitinol stents].

OBJECTIVE: Percutaneous peripheral interventional procedures as well as coronary interventions can be complicated by dissections and traumatic lesions of peripheral arteries. The aim of this study was to evaluate the efficacy of fabric covered endoprostheses for percutaneous repair of traumatic peripheral arterial lesions. PATIENTS AND METHODS: In this study we used the EndoPro 1/Passager device (Boston Scientific, USA), which is a self-expanding nitinol stent covered by an ultrathin layer of dacron fabric. In 27 patients a total number of 31 endoprostheses (mean length 7.3 cm) were implanted in iliac (n = 20), femoral (n = 6) and popliteal arteries (n = 1). Indications for stenting were large dissections (n = 24), arterial perforations (n = 2) and one traumatic arterio-venous fistula. RESULTS: An immediate exclusion of the lesion could be achieved in all cases. There were no major procedural complications. However, within 24 hours after implantation 14 patients (51.9%) developed fever. WBC and CRP were elevated in 13 (48.1%) and 17 (63%) patients, respectively. Repeated blood cultures could not show any bacterial growth. The primary patency after a mean follow-up of 19 (5 to 31) months was 85.2%. In two cases with markedly impaired peripheral run-off subacute graft occlusions occurred. In 2 other cases the angiography revealed relevant restenoses (> 75%). The patency could be restored in 2 of these 4 cases leading to a secondary patency rate of 92.6%. CONCLUSIONS: The EndoPro 1/Passager endoprosthesis seems to be safe and effective to seal large dissections and traumatic lesions of peripheral arteries, showing a high long-term patency rate.

Adult↗

PubMed2000

[Perforations in recanalization of arterial occlusions of the femoropopliteal area].

Interventional recanalizations may induce wall perforations. The aim of this study was to evaluate the incidence and the management of this complication in chronic femoropoliteal occlusions. 512 cases undergoing interventional recanalization (PTA or Excimer laser-assisted angioplasty) of femoropopliteal occlusions between 5 and 32 cm in length (mean: 13.8 cm) were included. Perforations were immediately examined by angiography or colour-coded ultrasonography (7.5 MHz). Perforations were observed in 22/512 cases (4.3%). The event was coincident with guide-wire manipulations in 16/512 cases (3.1%), laser catheter advancement without wire guidance in 3/58 cases (5.2%), and balloon dilatation in 3/431 cases (0.7%), while lasering via wire guidance (n = 408) did not induce perforation. Combining treatment with prolonged balloon dilatation (success: 6/8, recurrent bleeding: 4/6), ultrasound-guided compression (UGC; success: 20/20) and regulation of anticoagulation, all active bleedings could be terminated. Due to perforation, 12/512 cases (2.3%) required repeated interventions for successful recanalization. Except hematomas of 15-320 ml volume (ultrasound measurement) and prolonged hospital stays for 24-72 h, no further clinical sequelae resulted. In conclusion, perforations occurring during recanalization of long and chronic femoropopliteal occlusions have to be considered as primary interventional failure. However, with immediate treatment including UGC, the risk of serious clinical sequelae is low.

Aged↗

PubMed1999

Stent-supported reconstruction of the aortoiliac bifurcation with the kissing balloon technique.

BACKGROUND: Bilateral iliac artery obstructions involving the aortic bifurcation or high-grade stenosis of the abdominal aorta are not usually considered an indication for percutaneous treatment. The purpose of the present study was to evaluate the initial and long-term results of primary stent implantation for reconstruction of the aortic bifurcation. METHODS AND RESULTS: In 48 patients with obstructions of the aortoiliac segment, primary stent implantation was performed with the "kissing balloon technique." Preinterventional angiography showed bilateral stenoses (>85%) of the proximal common iliac arteries in 25 patients, unilateral occlusions and contralateral stenosis in 22 patients, and bilateral occlusion in 1 patient. In 7 cases, stents were placed for the treatment of high-grade infrarenal aortic stenoses. After excimer laser-assisted recanalization of the common iliac artery obstructions, the aortic bifurcation was reconstructed with the bilateral simultaneous implantation of Palmaz stents (diameter, 7 to 8 mm). Stents used for the treatment of aortic stenoses (Palmaz, n=6; Gianturco, n=1) had a diameter ranging from 20 to 25 mm. In all patients, stents were placed successfully (residual stenosis <30%) and without complications. A clinical improvement of +2 to +3 according to American Heart Association criteria was observed in 41 and 7 patients, respectively. Follow-up was performed clinically (standardized treadmill testing and color-coded Doppler ultrasound) and angiographically. The primary angiographic patency rate (24-month follow-up) was 86.8%. In 3 patients, angiography revealed significant restenoses, which were successfully treated with percutaneous transluminal angioplasty. CONCLUSIONS: Primary stent implantation with the kissing balloon technique is safe and effective for the treatment of aortoiliac obstructions involving the aortic bifurcation and represents a true endovascular alternative to surgery.

Angioplasty, Balloon↗