[Results in stent implants in pelvic arteries: follow-up with color-coded duplex ultrasonography]

Thirty-one patients (26 males, 5 females), treated with percutaneously inserted endoprostheses (stents) in the iliac artery were followed up a mean 1 year (2-60 months) with regard to clinical and non-invasive results, by color duplex ultrasound and (8 cases) angiography. With one exception self-expandable stents (Wallstents) were applied. The indications for stent implantation were PTA-resistant lesions in 78% and treatment of acute complications after PTA in 22%. Primary technical success with an open stent was achieved in all patients. The ankle-arm systolic pressure index (ASPI) increased from mean 0.67 +/- 0.14 to 0.88 +/- 0.17 (p < 0.001). Early stent occlusion occurred in 1 patient (3%), and 9 (24%) further complications (thrombosis, distal embolization, puncture site problems) were treated either by conservative or interventional procedures, and only once by surgical revision. Color duplex ultrasound showed all stents open without stenosis of hemodynamic significance. Angiography demonstrated intimal hyperplasia in 2 patients with stenosis of about 20-25%. At follow-up 61% of the patients were asymptomatic, 32% were improved. Remaining symptoms were due to lesions of the distal arteries and not to obstructions of the stents. Stenting of iliac arteries is a safe and effective treatment for recurrent and/or complex iliac lesions and has become a valuable adjunct in catheter interventions. We conclude that color duplex ultrasound is not only applicable in native arteries but also in stents, and gives reliable results with regard to hemodynamically relevant obstructions.