INTRAARTERIAL PRESSURE-GRADIENTS AFTER RANDOMIZED ANGIOPLASTY OR STENTING OF ILIAC ARTERY LESIONS

Purpose: To determine initial technical results of percutaneous transl uminal angioplasty (PTA) and stent procedures in the iliac artery, mea n intraarterial pressure gradients were recorded before and after each procedure. Methods: We randomly assigned 213 patients with typical in termittent claudication to primary stent placement (n = 107) or primar y PTA (n = 106), with subsequent stenting in the case of a residual me an pressure gradient of > 10 mmHg (n = 45). Eligibility criteria inclu ded angiographic iliac artery stenosis (> 50% diameter reduction) and/ or a peak systolic velocity ratio > 2.5 on duplex examination. Mean in traarterial pressures were simultaneously recorded above and below the lesion, at rest and also during vasodilatation in the case of a resti ng gradient less than or equal to 10 mmHg. Results: Pressure gradients in the primary stent group were 14.9 +/- 10.4 mmHg before and 2.9 +/- 3.5 mmHg after stenting. Pressure gradients in the primary PTA group were 17.3 +/- 11.3 mmHg pre-PTA, 4.2 +/- 5.4 mmHg post-PTA, and 2.5 +/ - 2.8 mmHg after selective stenting. Compared with primary stent place ment, PTA plus selective stent placement avoided application of a sten t in 63% (86/137) of cases, resulting in a considerable cost saving. C onclusion: Technical results of primary stenting and PTA plus selectiv e stenting are similar in terms of residual pressure gradients.