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[Percutaneous revascularization of chronic iliac artery occlusions with primary stent placement]
1Servicio de Radiología Intervencional y Terapia Endovascular, Hospital Clínico Pontificia Universidad Católica de Chile.
Insights
Percutaneous revascularization with stent placement effectively treats chronic iliac artery occlusions. This endovascular approach offers a valid alternative to surgery, improving patient outcomes and limb perfusion.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Therapy
Context:
- Aortoiliac stenoses are commonly treated with angioplasty, but success is limited in arterial occlusions.
- Vascular stent placement can significantly improve outcomes for these challenging cases.
Purpose:
- To evaluate the effectiveness of percutaneous revascularization with stent placement for chronic iliac artery occlusions.
- To assess technical and clinical success rates, as well as long-term permeability and patient outcomes.
Summary:
- Twenty-six patients with chronic iliac artery occlusions underwent percutaneous revascularization with stent placement.
- Technical success was achieved in 23 patients, with significant improvement in ankle-arm index (0.49 to 0.88).
- Twelve-month permeability was 81%, and 36-month permeability was 65%, with manageable complications.
Impact:
- Percutaneous revascularization with stenting is a viable alternative to surgical intervention for selected patients with chronic iliac artery occlusion.
- The procedure demonstrates favorable long-term patency rates and improves peripheral circulation.
- Endovascular techniques provide effective solutions for potential complications.
Background:
Percutaneous transluminal angioplasty is a well established treatment method for aorto iliac stenoses. However its success is limited in arterial occlusions and vascular stent placement can improve the results.
Aim:
To assess the effectiveness of percutaneous revascularization with stent placement in patients with chronic iliac artery occlusions.
Patients And Methods:
Twenty six patients (18 male) aged 47 to 82 years, with iliac artery occlusions lasting six or more weeks were treated. Fourteen had involvement of common iliac artery, five had involvement of external iliac artery and seven of both. The occluded segment length ranged from 3.5 to 12 cm. According to the Society of Cardiovascular Surgery/International Society for Cardiovascular Surgery classification, 22 patients had category 1 claudication, 10 were in category 2, 12 in category 3 and two in category 4.
Results:
A technical success was obtained in 23 patients and clinical success in 21. After the intervention, the anklearm index improved from 0.49 +/- 0.12 to 0.88 +/- 0.18 (p < 0.001). Permeability after 12 months of follow up was 81% and after 36 months, 65%. Four patients had complications; one had a vascular perforation, two had an acute occlusion and one had an asymptomatic distal embolization. All these were solved using endovascular techniques.
Conclusions:
Percutaneous revascularization with stent placement is a valid alternative to surgery in selected patients with chronic iliac artery occlusion.