Subintimal angioplasty of chronic total occlusion in iliac arteries: A safe and durable option

Abstract

This study demonstrates that SIA of iliac CTOs is feasible and can be performed safely and effectively, even in high-risk patients. Excellent patency and limb salvage rates can be achieved. In our experience, the safety and durability of SIA makes it an attractive first-line therapy for iliac artery occlusive disease.

Efficacy of stent-supported subintimal angioplasty in the treatment of long iliac artery occlusions

“…SA has been primarily used for recanalizing long femoropopliteal or tibial occlusions with relatively high technical success rates; however, only a few studies have described the outcomes of SA in iliac lesions. [9][10][11][12] Thus, the aim of this study was to investigate the procedural and clinical outcomes of SA in long occlusive lesions of iliac arteries and compare them with those of intraluminal angioplasty (IA) in nonocclusive long lesions of iliac arteries.…”

The effect of demographic factors and lesion severity on iliac stent patency

“…16 However, in our institution's previous experience with subintimal angioplasty and selective stenting of iliac chronic total occlusions, no statistical difference was found between EIA and CIA involvement. 17 On univariate analysis, CIA stenoses showed a protective effect on PP, which failed to remain significant upon multivariate analysis. This may relate to a higher proportion of those with CIA stenoses receiving kissing stents.…”

Recanalization of flush iliac occlusions with the assistance of a contralateral iliac occlusive balloon

“…8 Furthermore, retrograde attempts typically require the use of expensive re-entry devices that are associated with significant costs 9 but still do not guarantee technical success. 4,8 The technique we have described here is simple but valuable in increasing technical success. We believe approaching these lesions by starting at the proximal cap of the iliac occlusion can increase the technical success rate because it is easier to regain true lumen access from this antegrade approach.…”

“…2 A second option, stenting for a TransAtlantic Inter-Society Consensus D lesion, has been performed with encouraging results. [2][3][4] Endovascular recanalization and stenting of chronic iliac occlusions can be performed under local anesthesia and as an outpatient procedure, which makes it an attractive alternative for patients who are at high risk for open aortic surgery or general anesthesia, or both. 2 "Flush" arterial occlusions (ie, chronic occlusions that begin at the proximal-most origin of the artery) are difficult to manage by endovascular means, as we learned from treating flush superficial femoral artery occlusions.…”