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Percutaneous transluminal angioplasty of the iliac arteries: 66 experiences
Insights
Percutaneous transluminal angioplasty (PTA) effectively treats iliac artery atherosclerotic occlusive disease, achieving high success rates for stenotic lesions. PTA offers a favorable alternative to surgery, especially for single stenotic lesions, with excellent short-term patency.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Radiology
Background:
- Atherosclerotic occlusive disease affects iliac arteries, often necessitating intervention.
- Iliac artery disease can be primary or associated with femoropopliteal disease.
- Percutaneous transluminal angioplasty (PTA) is a minimally invasive treatment option.
Observation:
- Sixty-six iliac arteries in 45 patients underwent PTA for atherosclerotic occlusive disease.
- 103 lesions were dilated, located in common and external iliac arteries.
- Patients presented with primary iliac disease or combined femoropopliteal disease.
Findings:
- An 84% primary success rate was achieved for stenotic lesions.
- Recanalization of totally occluded iliac arteries had a 33% success rate.
- PTA was unsuccessful in 12 patients, with only three severe complications requiring surgery.
- A 100% patency rate was observed within the follow-up period (less than 2 years).
Implications:
- PTA is the preferred treatment for single stenotic iliac artery lesions.
- The absence of calcification is a favorable prognostic factor for PTA success.
- Successful PTA can obviate the need for more invasive procedures like aortic bifurcation grafting.
Abstract:
Sixty-six iliac arteries in 45 patients, 25 male and 20 female, were treated with percutaneous transluminal angioplasty (PTA) for atherosclerotic occlusive disease. Of 103 lesions dilated, 51 were in common iliac and 51 in external iliac arteries. While iliac artery disease was the primary lesion in 18 patients, eight of whom had total occlusion, 27 patients had additional femoropopliteal disease. An overall primary success rate of 84% in dilatation of the stenotic lesions, and 33% in recanalization of totally occluded iliac arteries was achieved. In 12 patients, a prescheduled aortic bifurcation graft was cancelled. In one patient, in addition to recanalization of the occluded common iliac artery, the stenotic distal aorta was also successfully dilated. Angioplasty was unsuccessful in 12 patients. There were only three severe complications requiring surgical assistance. To date, less than 2 years, there has been a patency rate of 100%. Transluminal angioplasty is the treatment of choice for single stenotic lesions of the iliac arteries. Lack of calcification is not an absolute guarantee of success, but a favorable factor.