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

Roach, Amy; Larion, Sebastian; Ahanchi, Sadaf S.; Ammar, Chad P.; Brandt, Colin T.; Dexter, David J.; Panneton, Jean M.

doi:10.1016/j.jvs.2015.04.397

Cited by 8 publications

(6 citation statements)

References 17 publications

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“…As noted in the literature, anatomic characteristics may be related to crossing approaches. Severe calcification, thrombosis, and rigid plaques are hindrances for the advancement of guidewires in the true lumen [10,11]. Statistically, we found that longer lesions with severe TASC categories were more likely to be crossed with the antegrade approach.…”

Section: Discussionmentioning

confidence: 69%

“…According to the TASC II guidelines, open surgery remains the gold standard of treatment for complex aortoiliac disease because it has excellent short- and long-term patency rates, which are as high as 85–92% [ 11 , 16 , 17 ]. The primary 2-year patency rate for complex and extensive lesions treated with endovascular procedures was 94% in one multicenter study, which is comparable to the outcomes of TASC A and B lesions [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness and long-term outcomes of different crossing strategies for the endovascular treatment of iliac artery chronic Total occlusions

Zhang

Niu

et al. 2020

BMC Cardiovasc Disord

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Background The iliac occlusive disease is usually treated with endovascular procedures in recent years. The effectiveness of different crossing approaches for these occlusions is not precisely known. We performed a retrospective study to explore the optimal crossing approach (antegrade versus retrograde) for iliac artery chronic total occlusions (CTOs) and to examine the long-term outcomes. Materials and methods We performed a study on 107 patients (116 iliac occlusive lesions, mean age 64.0 ± 11.1, 88 men) who underwent an iliac CTO endovascular intervention attempted with the use of both crossing strategies but were managed with one final crossing approach between August 2012 and August 2018. Baseline data, procedural characteristics, and outcomes were described. A Cox proportional hazard model and Kaplan-Meier method were developed to assess the differences in the two crossing approaches in terms of the 1-year and 5-year primary patency rates, target lesion revascularization (TLR) and major adverse limb events (MALEs). Results Common iliac artery (CIA) lesions were more likely to be crossed successfully in the retrograde direction (6.8% for antegrade vs. 20.9% for retrograde, p = 0.005), while lesions in the CIA/ external iliac artery (EIA) were more prone to be crossed successfully in the antegrade direction (58.9% for antegrade vs. 39.5% for retrograde, p = 0.016). There were no significant differences in the crossing approach for EIA lesions between the two groups. The two crossing approaches were associated with similar estimates of 1- and 5-year primary patency, TLR and MALE rates. Conclusion The antegrade approach was associated with a higher rate of successful crossing in CIA/EIA CTO lesions, while the CIA-only CTOs were more likely to be crossed successfully with the retrograde approach.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Effectiveness and long-term outcomes of different crossing strategies for the endovascular treatment of iliac artery chronic Total occlusions

Zhang

Niu

et al. 2020

BMC Cardiovasc Disord

View full text Add to dashboard Cite

show abstract

“…As noted in the literature, anatomic characteristics may be related to crossing approaches. Severe calci cation, thrombosis, and rigid plaques are hindrances for the advancement of guidewires in the true lumen [10,11]. Statistically, we found that longer lesions with severe TASC categories were more likely to be crossed with the antegrade approach.…”

Section: Discussionmentioning

confidence: 71%

“…According to the TASC II guidelines, open surgery remains the gold standard of treatment for complex aortoiliac disease because it has excellent short-and long-term patency rates, which are as high as 85%-92% [11,16,17]. The primary 2-year patency rate for complex and extensive lesions treated with endovascular procedures was 94% in one multicenter study, which is comparable to the outcomes of TASC A and B lesions [18].…”

Section: Discussionmentioning

confidence: 85%

Effectiveness and Long-term Outcomes of Different Crossing Strategies for the Endovascular Treatment of Iliac Artery Chronic Total Occlusions

Zhang

Niu

et al. 2020

Preprint

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Background: The iliac occlusive disease is usually treated with endovascular procedures in recent years. The effectiveness of different crossing approaches for these occlusions is not precisely known. We performed a retrospective study to explore the optimal crossing approach (antegrade versus retrograde) for iliac artery chronic total occlusions (CTOs) and to examine the long-term outcomes. Materials and Methods: We performed a study on 107 patients (116 iliac occlusive lesions, mean age 64.0±11.1, 88 men) who underwent an iliac CTO endovascular intervention attempted with the use of both crossing strategies but were managed with one final crossing approach between August 2012 and August 2018. Baseline data, procedural characteristics, and outcomes were described. A Cox proportional hazard model and Kaplan-Meier method were developed to assess the differences in the two crossing approaches in terms of the 1-year and 5-year primary patency rates, target lesion revascularization (TLR ) and major adverse limb events (MALEs ). Results: Common iliac artery (CIA ) lesions were more likely to be crossed successfully in the retrograde direction (6.8% for antegrade vs. 20.9% for retrograde, p=0.005), while lesions in the CIA/ external iliac artery (EIA ) were more prone to be crossed successfully in the antegrade direction (58.9% for antegrade vs. 39.5% for retrograde, p=0.016). There were no significant differences in the crossing approach for EIA lesions between the two groups. The two crossing approaches were associated with similar estimates of 1- and 5-year primary patency, TLR and MALE rates. Conclusion: The antegrade approach was associated with a higher rate of successful crossing in CIA/EIA CTO lesions, while the CIA-only CTOs were more likely to be crossed successfully with the retrograde approach.

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“…Younger patients who need aortoiliac intervention likely exhibit a more aggressive form of the disease, becoming symptomatic at an earlier age and being more prone to atherosclerotic disease process after treatment and subsequent patency loss. [23][24][25] Therefore, further investigation warranted on how atherosclerotic processes or other clinical variables may differ between younger and older populations.…”

Section: Discussionmentioning

confidence: 99%

Midterm Outcomes on Primary Endovascular Treatment of 395 Aortoiliac Occlusive Disease Patients: A Single-Center Experience

et al. 2021

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We report the results of endovascular treatment of Trans-Atlantic Inter-Society Consensus II (TASC) A&B, TASC C, and TASC D aortoiliac lesions in a single vascular center. In this retrospective, observational cohort study, we analyzed 395 patients (mean age 61.2 ± 9.0; 359 men) between January 2015 and December 2017. Technical success was achieved in 96.5%; in-hospital mortality was 1.2% (n = 5). Median follow-up was 36 months (range 24-49 months). After 1 and 5 years, the primary patency rates were 99% and 85% for TASC A&B, 90%, and 78% for TASC C, and 90% and 74% for TASC D. Secondary patency rates were 99% and 90% for TASC A&B, 98% and 65% for TASC C, and 97% and 65% for TASC D. Previous peripheral revascularization (hazard ratio: 1.76, 95% CI: 1.01-3.08, P = .04) was associated with decreased primary patency along with lower age, TASC C, and TASC D class. This analysis reported the acceptable effectiveness and safety of stenting for all types of aortoiliac occlusive disease in a modern setting, with few complications and excellent long-term primary and secondary patency rates.

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

Abstract: In our experience with a large number of iliac interventions, younger age, non-Caucasian race, and EIA occlusion were strong predictors for loss of PP.

Cited by 8 publications

References 17 publications

Effectiveness and long-term outcomes of different crossing strategies for the endovascular treatment of iliac artery chronic Total occlusions

Effectiveness and long-term outcomes of different crossing strategies for the endovascular treatment of iliac artery chronic Total occlusions

Effectiveness and Long-term Outcomes of Different Crossing Strategies for the Endovascular Treatment of Iliac Artery Chronic Total Occlusions

Midterm Outcomes on Primary Endovascular Treatment of 395 Aortoiliac Occlusive Disease Patients: A Single-Center Experience

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