LONG-TERM FOLLOW-UP OF THE PALMAZ STENT FOR ILIAC OCCLUSIVE DISEASE

Background. Thirty-eight limbs with iliac occlusive disease were treat ed with Palmaz stents from 1987 through 1991. Methods. Indications for stent utilization included dissection induced By percutaneous translu minal balloon angioplasty (PTA) (10), restenosis after PTA (nine), pos t-PTA residual stenosis (nine), multiple stenoses or occlusion (five), and unfavorable location (five). Results. The ankle/brachial pressure index increased from 0.53 +/- 0.27 to 0.8 +/- 0.26 after stent deploy ment. The intraluminal pressure gradient decreased from 31.9 +/- 16.3 to 0.9 +/- 2.2 mm Hg after stent deployment. Complications included ps eudoaneurysm (one), arteriovenous fistula (one), iliac perforation (on e), groin hematoma (two), and occlusion (two). Follow-up arteriogram s howed stenosis proximal or distal (n = 4) or within the stents (n = 4) . These were treated with PTA or stents. Two patients required an aort obifemoral graft. Nine patients have died. Life table analysis showed a 1-, 3-, and 5-year primary and secondary cumulative patency of 87%: +/- 5.9%, 74% +/- 8.2%, and 63% +/- 10% and 91% +/- 5.1%, 91% +/- 5.6% , and 86% +/- 7.6%, respectively. Conclusions. Palmaz stents, often re quired to salvage a PTA failure, appear to maintain overall patency at a high level. However, intimal hyperplasia and the progression of ath erosclerotic disease may result in a need for additional procedures to obtain this favorable outcome.