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Intraluminal stents in atherosclerotic iliac artery stenosis: preliminary report of a multicenter study
J C Palmaz1, G M Richter, G Noeldge
1Department of Radiology, University of Texas Health Science Center, San Antonio 78284-7800.
Insights
Balloon-expandable stents effectively treated iliac artery stenosis in 15 patients. This intervention relieved intermittent claudication and improved limb salvage, with sustained benefits at 6-12 months follow-up.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Peripheral Artery Disease
Background:
- Iliac artery stenosis significantly impacts patient mobility and limb viability.
- Symptomatic patients often experience intermittent claudication or critical limb ischemia.
- Traditional treatments may carry substantial risks or limitations.
Purpose of the Study:
- To evaluate the efficacy of balloon-expandable stent placement for symptomatic iliac artery stenosis.
- To assess the impact of stenting on transstenotic gradients and hemodynamic indices.
- To determine the clinical outcomes and durability of stent treatment in this patient cohort.
Main Methods:
- Fifteen patients with symptomatic iliac artery stenosis underwent stent placement.
- Stents were deployed intraluminally, primarily via percutaneous transluminal angioplasty.
- Hemodynamic parameters (transstenotic gradient, ankle-arm index) were measured pre- and post-procedure.
Main Results:
- Mean transstenotic gradient decreased significantly from 32.3 mm Hg to 3.1 mm Hg post-stenting.
- Ankle-arm Doppler systolic pressure index improved from 0.68 to 0.96.
- Intermittent claudication resolved in 14 patients; exercise tolerance improved in the limb-at-risk patient.
Conclusions:
- Intraluminal balloon-expandable stent placement is a highly effective treatment for iliac artery stenosis.
- The procedure leads to significant hemodynamic improvement and symptom resolution.
- Stenting offers a valuable, durable solution for managing iliac artery disease with sustained clinical benefits.
Abstract:
Fifteen patients with symptomatic iliac artery stenosis were treated with intraluminal placement of balloon-expandable stents. Before treatment, 14 patients had intermittent claudication, and one had a limb at risk for amputation. One patient had diabetes mellitus, nine had hypertension, and all were long-term smokers. Two patients had surgical placement of the stent; in one patient this was part of a combined revascularization procedure. All other stents were placed percutaneously. The transstenotic gradient after injection of vasodilating drugs distal to the lesion decreased from a mean of 32.3 mm Hg +/- 16.7 to 3.1 mm Hg +/- 4.2 after stent placement. Ankle-arm Doppler systolic pressure index increased from a mean of 0.68 +/- 0.22 to 0.96 +/- 0.24 after the procedure. The treatment eliminated intermittent claudication in 14 patients and increased exercise tolerance to 500 m in the patient with a limb at risk for amputation before the procedure. The improved condition persisted in all patients during the follow-up of 6-12 months. Stent placement may be a valuable adjunct in the management of iliac artery disease.