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[Stents in the iliac arteries: a minimally invasive method]
A Thalhammer1, J Balzer, V Jacobi
1Institut für diagnostische und interventionelle Radiologie, Klinikum der Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, 60590 Frankfurt am Main. axelthalhammer@hotmail.com
Aim:
We demonstrate patients to reveal the conditions for good results with respect to acute and long term out-come of interventional therapy of iliac artery occlusion.
Material And Methods:
225 Patients with aortoiliacal occlusion who underwent surgery or intervention were evaluated. All patients were discussed in an interdisciplinary angiologic conference. 63 patients primary had an operation, 161 patients primary were treated by intervention. The two cohorts were compared concerning their structure, the primary success and the primary and secondary patency over one year.
Results:
Both cohorts showed significant differences, the surgical treated patient had a higher clinical stage as well as more complex iliacal occlusion. The interventional treated patients had higher comorbidity. Primary technical success and patency rates did not show any difference. The complication rate was equally low in both cohorts. In percutaneous treated patients after predilatation, embolization into the periphery occurred. With primary stent PTA, there was no embolization.
Conclusion:
The percutaneous recanalization also of long iliac occlusion is a save, successful alternative to surgery. Nevertheless, there are limits. For optimal therapy management an interdisciplinary consultation is necessary. To avoid embolization, after recanalization primary stent PTA should be performed.