Clinical outcomes with contemporary endovascular therapy of iliac artery occlusive disease
Philip B Dattilo1, Thomas T Tsai, Joel A Garcia
1Department of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA.
Insights
Endovascular therapy for iliac artery occlusive disease (IAOD) shows high technical success and good patency rates. This approach is validated for complex IAOD cases.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Interventions
Background:
- Iliac artery occlusive disease (IAOD) management is evolving with endovascular techniques.
- Assessing outcomes of endovascular revascularization for IAOD is crucial to validate its role.
Purpose of the Study:
- To evaluate clinical outcomes of patients with IAOD treated with contemporary endovascular technology.
- To assess acute procedural success, complications, and patency rates.
Main Methods:
- Retrospective analysis of a prospectively collected database of 59 patients undergoing 62 endovascular procedures for IAOD (Sept 2005-Sept 2010).
- Kaplan-Meier method used for estimating patency and mortality rates.
- Assessment of baseline characteristics, anatomic details, and procedural data.
Main Results:
- High technical success rate (97%) with no procedure-related mortality.
- Major complications occurred in 8% of procedures.
- At 1 year, primary and secondary patency rates were 86% and 94%; at 2 years, 77% and 91% respectively.
- TASC II classification did not predict outcomes.
Conclusions:
- Contemporary endovascular therapy demonstrates favorable acute and medium-term outcomes for complex IAOD.
- These results support an endovascular-first approach for IAOD revascularization.
Objectives:
We sought to evaluate the clinical outcomes of a consecutive series of patients treated for iliac artery occlusive disease (IAOD) using contemporary endovascular technology and techniques.
Background:
As an increasingly complex spectrum of IAOD is treated using endovascular revascularization, there is a need to examine the rates of acute procedural success, complications, and patency to validate the role of an endovascular-first approach to revascularization in contemporary practice.
Methods:
All patients with IAOD who were treated using endovascular therapy between September 2005 and September 2010 were identified from a prospectively collected database. Baseline patient characteristics, anatomic details, procedural data, and clinical outcomes were assessed retrospectively. Patency and mortality rates were estimated with the Kaplan-Meier method.
Results:
A total 59 patients underwent 62 procedures. Trans-Atlantic Inter-Society Consensus (TASC) II types B, C, and D disease accounted for 59%, 7%, and 37% of patients, respectively. The procedure was technically successful in 60 of 62 cases (97%) with no procedure-related mortality. Major complications occurred in five procedures (8%). The mean (±standard deviation) duration of follow-up was 2.3 ± 1.4 years. In patients with a successful revascularization, primary and secondary patency rates were 86% and 94% at 1 year, and 77% and 91% at 2 years, respectively. The TASC II classification of disease did not predict the rate of acute technical success or medium-term patency rates.
Conclusions:
The acute and medium-term clinical outcomes of this series of patients with anatomically complex IAOD support the current paradigm of an endovascular-first approach to revascularization.
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