Aortoiliac stenting, determinants of clinical outcome

Objectives: to determine predictors of clinical outcome in stenting aortoil iac disease. Design: prospective/retrospective study. Materials and methods: one hundred and forty patients (163 limbs) underwent iliac artery stenting in the period 1994-1997. Ninety-eight occlusions and 65 stenoses were treated, either with primary stenting (n=129) or after fa iled angioplasty (n=34). Median follow-up 18 months (1-66). Factors analyse d for their effect on outcome were: gender, age, Fontaine stage, ABI, lesio n type/length/site, primary or secondary stenting, stent type, BP, smoking, diabetes, aspirin, cholesterol, residual gradient, overhanging and run-off . Results: the immediate success was 95%. The primary successful clinical out come was 90% at 12 months and 84% at 36 months; the primary-assisted succes sful clinical outcome teas 95% at 12 months and 91% at 36 months and the se condary successful clinical outcome was 92% at 12 months and 87% at 36 mont hs. Adverse factors affecting outcome were: residual pressure gradient (>10 mmHg) and no treatment with aspirin (p<0.05). Major complications occurred in 18% of patients with a re-intervention in 8%. The 30-day mortality was 5.5%. Conclusions: stenting for aortoiliac occlusive disease has good shout and l ong term clinical success, with low morbidity and mortality. Factors that m ight improve results further are ensuring that patients are taking aspirin and any residual pressure gradient is abolished.