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Chronic iliac artery occlusion: treatment with the Strecker stent after PTA
L Lupattelli1, A Maselli, F Barzi
1Department of Radiology, University of Perugia, Policlinico Monteluce, Italy.
Insights
Percutaneous transluminal angioplasty with Strecker stent implantation effectively treats chronic iliac artery occlusions. This minimally invasive procedure significantly improves patient symptoms and limb perfusion, demonstrating high patency rates.
Area of Science:
- Vascular Surgery
- Interventional Radiology
Background:
- Chronic iliac artery occlusions significantly impair limb perfusion and quality of life.
- Percutaneous transluminal angioplasty (PTA) is a common treatment, but often requires adjunctive stenting for sustained patency.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous transluminal angioplasty (PTA) combined with Strecker stent implantation for chronic iliac artery occlusions.
Main Methods:
- A retrospective study of 39 patients with chronic iliac artery occlusions treated with PTA and Strecker stenting.
- Occlusion lengths ranged from 4.5 to 10.5 cm, involving common and/or external iliac arteries.
- Patients were assessed based on Fontaine classification and Doppler sonographic ankle-arm index (AAI).
Main Results:
- 37 out of 39 patients demonstrated a significant increase in AAI (P = 0.001) and improved clinical symptoms.
- 27 patients improved to Fontaine stage I, 10 to stage IIa; two patients had no change.
- A 6-month patency rate of 89.7% was observed, with two cases of complete occlusion and two minor complications (hematoma, embolization).
Conclusions:
- Percutaneous transluminal angioplasty (PTA) with Strecker stent implantation is a safe and effective treatment for chronic iliac artery occlusions.
- The combined approach leads to significant clinical improvement and high long-term patency.
- Strecker stents offer a viable option for managing complex iliac artery lesions.
Abstract:
The purpose of this retrospective study was to evaluate the use of percutaneous transluminal angioplasty (PTA) and subsequent. Strecker stent implantation for the treatment of chronic iliac artery occlusions. A total of 39 patients were subjected to this procedure. The occluded vessels were catheterized, dilated and subjected to stenting in all patients: the length of occlusion varied from 4.5 to 10.5 cm (mean 5.9), lesions were located in common iliac arteries (25), external iliac arteries (10) and in combinations of both (4). Twenty-five patients presented stage II according to Fontaine classification, nine patients stage III and five patients stage IV. The stent was mounted on balloon catheter and introduced through a 9 French sheet (for 8-10 mm stent diameter). After this procedure, 37 out of 39 patients showed a statistically significant increase in the Doppler sonographic ankle-arm index (AAI) (P = 0.001) and improvement of clinical symptoms, while in two patients a complete occlusion resulted due to long dissection not covered by the stent in one case and to stent misplacement in the other case. After stenting, 27 patients improved to stage I, ten patients to stage IIa and two patients showed no changes. Two complications were observed: one groin hematoma and one distal embolization. At a 6-month follow-up, a 89.7% of patency was observed. This study shows that Strecker stent can be successfully employed in addition to PTA to treat occlusions of the iliac arteries.