Midterm Results of the Treatment of Penetrating Abdominal Aortic or Iliac Artery Ulcer with the BeGraft Balloon Expandable Covered Stent. Single Center Experience.

Abstract: Background The purpose of the study was to evaluate the feasibility and efficacy of the novel BeGraft covered stent for the treatment of abdominal penetrating aortic ulcer (PAU) or penetrating ulcer of the iliac arteries (PUIA). Methods This was a single-center observational study, including 24 consecutive patients undergoing endovascular surgery due to abdominal PAU or PUIA between June 2017 and September 2019. Demographics of patients, lesion characteristics, diameter, and length of the BeGraft stents, post-operative events were prospectively collected and retrospectively analyzed. Follow-up examinations were done at 1, 6, 12, and 24 months with clinical and hemodynamic evaluation. Outcome measures included technical success, peri-operative complications, and stent patency. Results 24 patients (13 male and 11 female), median age 67 years (range 42-81 years), were analyzed. Twenty patients were symptomatic, and four patients underwent elective surgery due to the size of PAU. A total of 54 BeGraft stents (26 aortic and 28 peripheral) were successfully delivered and deployed to cover 13 aortic and 13 common iliac artery ulcer lesions. The technical success rate was 100%. The average procedural time was 53.8±12.8 min. Complications included one case of the access-site pseudoaneurysm, which was successfully treated by thrombin injection. During a median follow-up of 20.5 months (range 6-33 months), all stents remained patent, without endoleak or ulcer recurrence. Conclusions BeGraft stents used during endovascular treatment of abdominal PAU and PUIA lesions are associated with favorable outcomes regarding technical success and patency. The primary use of BeGraft covered stents provides a valid option for patients with abdominal penetrating aortic ulcer. Long-term follow-up is required to confirm these promising results.