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Early experience with stenting for iliac occlusive disease
G J Toogood1, E P Torrie, T R Magee
1Department of Surgery, Royal Berkshire Hospital, Reading, U.K.
Summary
Iliac artery stenting is effective for stenoses, but complete occlusions present challenges. Successful stenting yields high patency rates for both conditions, despite a learning curve for occlusions.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Interventions
Background:
- Iliac artery occlusive disease significantly impacts patient mobility.
- Endovascular stenting offers a minimally invasive treatment option.
Purpose of the Study:
- To evaluate the outcomes of iliac artery stenting for occlusive disease.
- To assess the safety and efficacy of stenting in stenotic versus occlusive iliac lesions.
Main Methods:
- Prospective study of 50 patients with iliac occlusive disease (November 1993-November 1996).
- Stenting indications included complete occlusion, restenosis, bypass inflow, and difficult stenoses.
- Patient presentation primarily involved intermittent claudication.
Main Results:
- Successful stenting achieved in all 13 stenoses, with high long-term patency.
- Stenting complete occlusions had a higher complication rate and technical failure.
- Intention-to-treat patency for occlusions was 65% at 2 years, improving to 88% after excluding failures.
Conclusions:
- Stenting complete iliac occlusions involves a steep learning curve and higher complication risk.
- Successful iliac stenting, for both stenoses and occlusions, demonstrates excellent patency rates around 90%.