TREATMENT OF CHRONIC ILIAC ARTERY OCCLUSIONS WITH GUIDE-WIRE RECANALIZATION AND PRIMARY STENT PLACEMENT

PURPOSE: To evaluate the results of primary stent placement without in itial thrombolysis in the treatment of iliac occlusions. MATERIALS AND METHODS: During a 3-year period, 61 iliac artery occlusions were trea ted in 59 patients, The mean length of the occluded segment was 10 cm (range, 4-25 cm), The occluded arteries were treated with primary plac ement of self-expandable metallic stents. RESULTS: Successful recanali zation with primary stent placement was possible in 56 of 61 occlusion s (92% technical success rate), Mean Doppler ankle/brachial index incr eased from 0.51 to 0.90 immediately after treatment and was 0.91 on th e last follow-up (P < .05), Primary patency rate at 24 months was 73%, and secondary patency rate was 88%, Procedural complications included distal embolization (n = 4) and an episode of massive intra-abdominal bleeding, Three patients developed a hematoma at the puncture site th at did not require additional therapy, Late complications included ste nt occlusion (n = 9) and significant stenosis related to intimal hyper plasia (n = 1), Mean follow-up period was 29 months (range, 755 months ). CONCLUSION: Primary stent placement is an effective therapeutic opt ion for iliac artery occlusions.