Initial Experience with the Covera Covered Stent for the Treatment of Dysfunctional or Thrombosed Arterio-Venous Grafts a Retrospective Analysis of 43 Patients

Background: To retrospectively evaluate the safety and effectiveness of the Covera covered stent (CS) for the treatment of dysfunctional or thrombosed arterio-venous grafts (AVGs). Method(s): Within 21 months (February 2016 – November 2017), 61 patients underwent CS placement in our department for the treatments of their dysfunctional AVGs. Data were available for 43 patients, undergoing 43 procedures, using 43 devices. Mean follow-up was 214 days (20-524 days). Lesion characteristics were as follows: 33 cases with venous-graft anastomosis (VGA) stenosis, 7 cases of puncture zone stenosis, 12 cases of in stent-graft (SG) stenosis, 5 cases of psuedoaneurysm treatment. Twenty-six patients presented with thrombosis while 26/43 case were restenotic lesions. Primary outcome measure was target lesion primary patency (TLPP) at six months, while secondary outcome measures included factors influencing primary outcome. Result(s): Technical success was 100%. TLPP was 60.64% at six months (median TLPP 264 days). During the whole follow-up period 17 AVGs were thrombosed and 11 cases required a redo procedure. There was no significant difference in terms of TLPP when de novo lesions were compared with restenotic, in SG restenosis vs. non in-SG stenosis, patients presented or not with thrombosis, or whether lesion was placed in the puncture zone or in VGA. A significant difference was observed between cases presented with thrombosis after treatment vs. those that were not thrombosed (133 vs. 285 days respectively. p=0.007). Conclusion(s): Use of the Covera CS for AVG treatment is safe and effective in every case presented in this retrospective analysis.

 

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Artikel online veröffentlicht:
11. Mai 2021