Technique, complication, and long-term outcome for endovascular treatment of iliac artery occlusion

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Interventions

Background:

• Chronic iliac artery occlusion presents significant challenges in vascular disease management.
• Endovascular techniques offer a minimally invasive alternative to traditional surgical approaches.
• Standardized reporting is crucial for evaluating the efficacy of endovascular treatments.

Purpose of the Study:

• To detail the technical aspects of endovascular treatment for chronic iliac artery occlusion.
• To report procedure-related complications and outcomes.
• To assess the long-term patency rates following endovascular intervention.

Main Methods:

• Retrospective review of 127 chronic iliac artery occlusions in 118 patients (2001-2008).
• All patients underwent stent placement, with or without preliminary balloon angioplasty.
• Kaplan-Meier analysis for patency rates; univariate and multivariate analyses for outcome predictors.

Main Results:

• High initial technical success rate (92%).
• Antegrade approach yielded higher successful recanalization rates (90%) compared to retrograde (50%).
• Five-year primary patency was 63%, and secondary patency was 93%; early stent thrombosis occurred in 7% of patients.

Conclusions:

• Endovascular treatment of chronic iliac artery occlusion is technically successful with good long-term results.
• The antegrade approach and presence of an arterial stump before occlusion are associated with improved recanalization success.
• Critical limb ischemia and major complications are predictors of early stent thrombosis, though not independent predictors of long-term stent patency.