Angioplasty and Stenting of Completely Occluded Iliac Arteries

Abstract

Percutaneous angioplasty and placement of balloon-expandable intraluminal stents were performed in 12 iliac occlusions in 12 patients. Indications were limb salvage in seven and claudication in five. After successful stenting, ankle-brachial indexes improved by 0.15 or more in 11 of 12 patients (mean increase, 0.40), transstenotic pressure gradients decreased to less than 5 mm Hg (mean, 0.58 mm Hg) in all patients, and improvement in clinical grade was seen in all patients. At follow-up at 1-14 months (median, 6 months), ankle-brachial indexes were stable (mean, 0.95), and clinical grades were unchanged in all patients. Complications occurred in two patients; both experienced distal embolization, and one, who was receiving corticosteroid therapy, also suffered stent thrombosis. Local surgical embolectomy was successful in both patients, and the thrombosed stent was recanalized with urokinase. This early experience suggests that stenting may play an important role in the management of iliac occlusions, especially in poor surgical candidates.

Usefulness of the Symphony Nitinol Stent for Arteriosclerosis Obliterans.

“…4 Similar results were reported by Gunther at al 5,6 and Murphy at al 7 Palmaz at al reported that the patency rate for the Palmaz stent at 8.7 months was 92%, and others have made a similar observation. [8][9][10][11][12] In the present study, the initial procedural success and patency rates (95% and 97%, respectively) are comparable with previous reports [4][5][6][7][8][9][10][11][12] and are considered equal to, or even superior to, the results obtained with the Wallstent or Palmaz stents.…”

Primary stent placement for iliac artery chronic total occlusions

“…Recent series of primary stent placement for CTOs reported the 2-year primary and secondary or assisted primary patency rates of 69%-93% and 85%-95%, respectively. [3][4][5][6][7][8][9][10][11][12] Our series demonstrated 2-year primary and assisted primary patency rates of 91% and 96%, at the high end of the range of recent reports. However, although our patency rates for primary stents placed for iliac CTOs were better than those reported for extra-anatomic bypasses, such as axillofemoral and femorofemoral bypasses, these patency rates were not better than the patency conventionally reported for aortobifemoral bypass.…”

Tratamento endovascular da oclusão das artérias ilíacas

“…Rees et al (14) realizaram angioplastia e implante de endoprótese em artérias ilíacas ocluídas de 12 pacientes, sendo as indicações salvamento de membro em sete deles e claudicação em cinco. Tiveram taxa de falência técnica de 20%.…”