Percutaneous treatment in iliac artery occlusion: long-term results

Cardiovasc Intervent Radiol. Nov-Dec 2008;31(6):1069-76. doi: 10.1007/s00270-008-9386-5. Epub 2008 Jul 29.

Abstract

We evaluated the long-term results of recanalization with primary stenting for patients with long and complex iliac artery occlusions. This was a retrospective nonrandomised study. Between 1995 and 1999, 138 patients underwent recanalization of an occluded iliac artery with subsequent stenting. Patency results were calculated using Kaplan-Meier analysis. The mean length of follow-up was 108 months. Variables affecting primary stent patency such as patient age; stent type and diameter; lesion site, shape, and length; Society of Cardiovascular and Interventional Radiology classification; total runoff score; Fontaine classification; and cardiovascular risk factors were analysed using Breslow test. These variables were then evaluated for their relation to stent patency using Cox proportional hazards test. Technical success was 99%. Primary patency rates were 90% (SE .024), 85% (SE .029), 80% (SE .034), and 68% (SE .052) at 3, 5, 7, and 10 years, respectively. Lesion site (p = 0.022) and stent diameter (p = 0.028) were shown to have a statistically significant influence on primary stent patency. Long-term results of iliac recanalization and stent placement were excellent, without major complications, even in highly complex vascular obstructions. A primary endovascular approach appears to be justified in the majority of patients as a less invasive alternative treatment to surgery. In any case, a first-line interventional approach should be considered in elderly patients or in patients with severe comorbidities.

MeSH terms

  • Angiography
  • Angioplasty, Balloon / methods*
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / therapy*
  • Female
  • Humans
  • Iliac Artery*
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / diagnostic imaging
  • Peripheral Vascular Diseases / therapy*
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Stents*
  • Survival Rate
  • Treatment Outcome
  • Vascular Patency