INFLUENCE OF ANATOMIC DISTRIBUTION OF ATHEROSCLEROSIS ON THE OUTCOME OF REVASCULARIZATION WITH ILIAC STENT PLACEMENT

PURPOSE: To determine the influence of clinical and angiographic varia bles, including the anatomic disease pattern, on the outcome of iliac stent placement.PATIENTS AND METHODS: The 455 patients of the study po pulation were divided in three groups according to the anatomic distri bution of their peripheral atherosclerosis lesions. Pattern type 1 (fo cal aortoiliac and/or common iliac lesion) included 180 patients (39.6 %), type 2 (external iliac lesion) comprised 58 patients (12.8%), and type 3 (multilevel lesions) included 217 patients (47.7%). RESULTS: Co mplete relief of symptoms immediately after revascularization was obse rved in 88.3% and 85.4% of patients with pattern type 1 and 2, respect ively, compared to 60.1% with type 3 (P < .05). The persistence of cli nical benefit at 36-month follow-up was 91.6%, 97.9%, and 60.8% in dis ease patterns 1, 2, and 3, respectively. The overall 1-year mortality rate was 3% with type 1 lesions, 5.7% with type 2, and 9.7% with type 3. On multivariate logistic regression, the presence of a disease patt ern type 3 was the most powerful indicator (P < .001) of early unsatis factory clinical outcome in iliac stent placement. Unexpectedly, femal e gender was predictive of unsatisfactory clinical outcome (P < .01) a nd higher periprocedural complications (P < .001) following iliac sten t revascularization. CONCLUSIONS: Pattern type classification helps id entify patients at higher risk for cardiovascular morbidity and mortal ity. Ideal candidates for iliac stent placement are patients with patt ern type 1 or 2 disease.