[Percutaneous angioplasty in iliac obstructions. Immediate and long-term results]

During the last 35 months, mechanical recanalisation was obtained in 25 (19 men, 6 women, aged 39 to 92 years, average 59 years) out of 30 patients admitted for percutaneous andovascular management, associating angioplasty and endovascular stents, of iliac artery occlusion of over 5 months duration. Forty-three balloon-expandable stents (27 Palmaz, 16 Strecker) were implanted in 29 iliac arteries (15 external, 14 common iliac arteries) with occlusions 2 to 7 cms long (average: 4.6 cm) either after balloon angioplasty (22 cases) or without angioplasty (7 cases) because of a suspected fresh thrombus suggested by easy recanalisation by the guide wire and with the aim of avoiding fragmentation and embolisation of the thrombotic material. In this type of case, a Strecker stent was preferred, a choice also justified by an "obligatory" contro-lateral approach (5 cases). With the exception of these cases, the treatment of first intention was to insert one or more Palmaz stents by a homo-lateral approach. Two haematomas with no complications and 1 reocclusion at the 24th hour, revascularised by urokinase with a good 6 months result, were observed. After the insertion of one Palmaz stent in one patient, a non-occlusive thrombus, probably due to embolism, was observed straddling the homolateral superficial and profunda femoral arteries, but it was of no clinical consequence. After thromboaspiration and angioplasty by a contro-lateral approach, the arterial lumen was recanalized with a sustained result at 18 months. Clinical Doppler and angiographic (digitised intravenous angioplasty) controls were obtained every 6 months in 22 patients.(ABSTRACT TRUNCATED AT 250 WORDS)