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Placement of balloon-expandable intraluminal stents in iliac arteries: first 171 procedures
J C Palmaz1, O J Garcia, R A Schatz
1Department of Radiology, University of Texas Health Science Center, San Antonio 78284-7800.
Insights
Balloon-expandable intraluminal stents effectively treated iliac artery disease in patients unresponsive to angioplasty. Most patients experienced significant clinical benefit, with many becoming asymptomatic post-procedure.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Devices
Background:
- Iliac artery stenoses and occlusions often require intervention.
- Conventional balloon angioplasty may not be sufficient for all patients.
- Intraluminal stenting offers a potential solution for refractory cases.
Purpose of the Study:
- To evaluate the efficacy and safety of balloon-expandable intraluminal stents.
- To assess outcomes in patients with iliac artery disease treated with stents after failed angioplasty.
- To analyze clinical benefit and complication rates associated with iliac stenting.
Main Methods:
- Retrospective analysis of 171 procedures in 154 patients with iliac artery stenoses/occlusions.
- Patients included those with limb-at-risk, severe, or moderate intermittent claudication.
- Follow-up averaged 6 months (range 1-24 months) to assess clinical outcomes and stent patency.
Main Results:
- 137 out of 154 patients (89%) demonstrated clinical benefit, with 113 becoming asymptomatic.
- Stent patency was maintained in all patients at follow-up, with no migration or aneurysm formation.
- Complications occurred in 18 patients, mostly minor (e.g., groin hematoma), with few device-related issues.
Conclusions:
- Balloon-expandable intraluminal stents are a safe and effective treatment for iliac artery disease refractory to balloon angioplasty.
- Stenting provides significant clinical improvement and maintains patency in the majority of treated patients.
- The procedure demonstrates a favorable risk-benefit profile, even in high-risk patient populations.
Abstract:
Balloon-expandable intraluminal stents were used to treat iliac artery stenoses or occlusions that failed to respond to conventional balloon angioplasty. One hundred seventy-one procedures were performed in 154 patients, of whom 48 had a limb at risk for amputation. Thirty-six had severe and 70 had moderate intermittent claudication. At the latest follow-up examination (average, 6 months; range, 1-24 months), 137 patients demonstrated clinical benefit, 113 of whom had become asymptomatic. Eleven patients showed no initial benefit, and six improved initially but later developed new vascular symptoms. Complications occurred in 18 patients. In three patients, complications were directly related to the device. Two occlusions were successfully recanalized, and an intramural collection of contrast material secondary to balloon perforation evolved favorably. The remaining patients had groin hematoma (n = 6), distal embolization (n = 4), extravasation (n = 2), transient renal failure (n = 1), pseudoaneurysm at the puncture site (n = 1), or subintimal dissection (n = 1). All stents have remained patent to the latest follow-up examination without evidence of migration or aneurysm formation.