TRANSFEMORAL TREATMENT FOR ILIAC OCCLUSIVE DISEASE WITH ENDOLUMINAL STENT-GRAFTS

Objectives: Percutaneous treatment of iliac artery occlusive disease h as replaced open vascular reconstruction for several indications. A ba lloon angioplasty with or without stent is not an option in the presen ce of infrainguinal extension of the disease. The authors describe a t echnique that allows the construction of an aorto-or iliofemoral graft through a single groin incision, using a 4 mm PTFE graft, anchoring i t proximally with a Palmaz stent and dilating both to tile desired dia meter. Design: Retrospective non-randomised study. Materials and Metho ds: Nineteen procedures were performed in 16 patients mainly because o f ischaemic vest pain, often with trophic skin changes or minor gangre ne. Three patients had a bilateral procedure. Twelve patients had one or more associated procedures: 10 distal bypasses, one thrombectomy, o ne reimplantation of a distal bypass on the iliofemoral graft, one con tralateral profundaplasty and two stents of the contralateral common i liac artery. Results: Two patients died, one of small bowel ischaemia and the other of a myocardial infarction. During the mean follow-zip o f 8.8 months, two graft thromboses occurred. In another patient bilate ral stenting of a residual stenosis was necessary. Conclusions: Our ex perience shows hat the reported technique is feasible. Whether the pro cedure is truly ''less invasive'' and the long-term results acceptable remains to be shown.