LifeStream plus Zenith stent graft effective for iliac aneurysm repair

The combined use of the LifeStream Balloon Expandable Vascular Covered Stent with the Zenith Bifurcated Iliac Side (ZBIS) stent graft can safely and feasibly preserve pelvic circulation for aortoiliac or isolated iliac artery aneurysm repair, a recent Korea study has found.

However, caution is still recommended as such an approach appears to yield an unexpectedly high rate of type 1c endoleaks.

The multicentre study included 38 patients (mean sage 72.7 years, 37 men) who received a total of 46 LifeStream Stents and 38 ZBIS stent grafts. All procedures were conducted for aneurysm repair. The primary outcomes of interest were technical success rate and procedure-related complications.

The iliac branch device (IBD) was successfully delivered in 29 patients without related endoleaks or graft limb occlusions, yielding a technical success rate of 76.3 percent. The remaining eight patients saw technical failure, including six instances of type 1c endoleaks, one type IIIc endoleak, one IIA occlusion by overstenting, and one failure to advance the graft due to stenosis.

Over a mean follow-up of 13.1 months, one patient died due to community-acquired pneumonia 5 months after the operation. Moreover, one case of occlusion occurred requiring cross-over femorofemoral bypass. Another episode of IIA branch occlusion also occurred at 12 months. Of the seven endoleaks during the procedure, four had spontaneously resolved 1 month after the procedure.

“Although an unexpected high rate of type Ic endoleaks was observed in several cases, LifeStream with ZBIS IBD is a safe and feasible protocol with good patency and a low rate of device-related reintervention,” the researchers said.