Percutaneous endovascular treatment of chronic iliac artery occlusion
F C Carnevale1, Mariano De Blas, Santiago Merino
1Department of Interventional Radiology, Institute of Radiology, University of Sao Paulo, Av. Dr. Enéas Carvalho de Aguiar 255, São Paulo 05403-001, Brazil. fcarnevale@uol.com.br
Insights
Percutaneous endovascular revascularization using balloon angioplasty and metallic stents effectively treats chronic iliac artery occlusion, showing high long-term patency and significant clinical improvement in patients.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Interventions
Background:
- Chronic iliac artery occlusion significantly impacts patient mobility and quality of life.
- Traditional surgical revascularization may carry higher risks for some patient groups.
Purpose of the Study:
- To assess the long-term clinical and radiological outcomes of recanalizing chronic occluded iliac arteries.
- To evaluate the efficacy and safety of balloon angioplasty and stent placement for iliac artery occlusion.
Main Methods:
- Sixty-nine chronic occluded iliac arteries in 67 patients underwent percutaneous transluminal angioplasty and stent placement.
- Clinical assessment (Fontaine stages), ankle-brachial index (ABI), and arteriography were used for evaluation.
- Wallstent and Cragg vascular stents were deployed, with a mean follow-up of 29.5 months.
Main Results:
- A technical success rate of 97.1% was achieved.
- Mean ABI improved significantly from 0.46 to 0.83 at follow-up.
- 92% of patients experienced clinical improvement, with primary and secondary patency rates of 75% and 95%, respectively.
Conclusions:
- Percutaneous endovascular revascularization with metallic stents is a safe and effective treatment for chronic iliac artery occlusion.
- High long-term patency rates and sustained clinical benefits support this minimally invasive approach.
Purpose:
To evaluate the clinical and radiological long-term results of recanalization of chronic occluded iliac arteries with balloon angioplasty and stent placement.
Methods:
Sixty-nine occluded iliac arteries (mean length 8.1 cm; range 4-16 cm) in 67 patients were treated by percutaneous transluminal angioplasty and stent placement. Evaluations included clinical assessment according to Fontaine stages, Doppler examinations with ankle-brachial index (ABI) and bilateral lower extremity arteriograms. Wallstent and Cragg vascular stents were inserted for iliac artery recanalization under local anesthesia. Follow-up lasted 1-83 months (mean 29.5 months).
Results:
Technical success rate was 97.1% (67 of 69). The mean ABI increased from 0.46 to 0.85 within 30 days after treatment and was 0.83 at the most recent follow-up. Mean hospitalization time was 2 days and major complications included arterial thrombosis (3%), arterial rupture (3%) and distal embolization (1%). During follow-up 6% stenosis and 9% thrombosis of the stents were observed. Clinical improvement occurred in 92% of patients. Primary and secondary patency rates were 75% and 95%, respectively.
Conclusion:
The long-term patency rates and clinical benefits suggest that percutaneous endovascular revascularization with metallic stents is a safe and effective treatment for patients with chronic iliac artery occlusion.
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