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Long-term results of stenting for chronic iliac artery occlusion
Petr Uher1, Ulf Nyman, Mats Lindh
1Department of Radiology, Malmö University Hospital, University of Lund, Malmö, Sweden. Petr.uher@rontgen.mas.lu.se
Insights
Stent placement for chronic iliac artery occlusions offers a safe and durable endovascular solution. This study shows high success rates and good long-term patency, making it a viable alternative to surgery.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Interventions
Background:
- Chronic iliac artery occlusions significantly impair lower limb perfusion.
- Surgical bypass has historically been the primary treatment, but carries substantial morbidity.
- Endovascular techniques, including stenting, have emerged as less invasive alternatives.
Purpose of the Study:
- To assess the long-term efficacy and safety of stent placement for treating chronic iliac artery occlusions.
- To compare outcomes of endovascular treatment with traditional surgical approaches.
Main Methods:
- A cohort of 73 patients with 76 chronic iliac occlusions underwent percutaneous recanalization and stenting between 1992 and 1997.
- A mix of self-expanding and balloon-expandable stents were utilized.
- Follow-up included clinical evaluation, ankle-brachial index, and imaging (arteriography/duplex ultrasound).
Main Results:
- Anatomical success was achieved in 97% of treated limbs.
- Major complications occurred in 10% of patients, with no 30-day mortality.
- At 3 years, primary and secondary patency rates were 69% and 81%, respectively, with recurrent lesions managed effectively by repeat endovascular or surgical interventions.
Conclusions:
- Stenting of chronic iliac occlusions provides a safe and durable treatment option.
- Endovascular stenting represents a valuable alternative to surgical revascularization for selected patients.
- Long-term patency rates support the durability of this interventional approach.
Purpose:
To evaluate the long-term results of stent placement for chronic occlusions of the iliac arteries.
Methods:
Between October 1992 and December 1997, 73 patients (40 men; median age 64 years, range 42-89) with 76 occluded iliac arteries (33 common, 34 external, and 9 both vessels) were treated with percutaneous recanalization and stenting using a variety of self-expanding and balloon-expandable devices. Median occlusion length was 7 cm (range 1-14). Follow-up consisted of clinical assessment, ankle-brachial index measurement, and arteriography or duplex ultrasound when indicated.
Results:
Anatomical success was achieved in 74 (97%) limbs. Seven (10%) patients experienced major complications: 2 distal embolizations, 2 arterial ruptures, 1 myocardial infarction, 1 groin hematoma requiring surgery, and 1 contrast-induced nephropathy. There was no 30-day mortality. Over a median follow-up of 27 months (range 1-75), there was 1 early occlusion (< or = 30 days) and 16 late recurrent lesions (11 occlusions and 5 stenoses) at a median 6.2 months (range 1.4-30). The recurrent lesions were treated with endovascular techniques in 8 limbs and surgery in 7 limbs (5 after failed endovascular procedures); 1 patient died before retreatment, and 1 patient refrained from further intervention. Primary and secondary patencies were 79% and 87% at 1 year and 69% and 81% at 3 years, respectively.
Conclusions:
Stenting of chronic iliac occlusions is a safe and durable alternative to surgical treatment.