PRIMARY STENTING FOR COMPLEX ATHEROSCLEROTIC PLAQUES IN AORTIC AND ILIAC STENOSES

Purpose: To evaluate the efficacy of primary stenting for complex athe rosclerotic plaques in aortic and iliac stenoses that are not amenable to balloon angioplasty alone. Methods: Nineteen patients with complex atherosclerotic plaques were treated with a Palmaz stent (n = 19), Wa llstent (n = 1), Strecker stent (n = 1), or Memotherm stent (n = 1). A total of 22 stenoses presenting with complex plaque morphology includ ing ulcerated plaques, ulcerated plaques with focal aneurysms, plaques with heavy calcification, severely eccentric plaques, plaques with ov erhanging edge, and plaques with spontaneous dissection were stented. The lesions were in the aorta (n = 1), common iliac artery (n = 19), o r external iliac artery (n = 2). Results: Immediate angiography after stent placement revealed restoration of patency of the stented segment . Focal aneurysms and ulcerated areas were occluded in the follow-up a ngiographies obtained 4-12 weeks after the procedure. In one case with poor distal runoff and multiple complex lesions of the iliac artery, subacute occlusion occurred. Clinical and angiographic follow-up (3-46 months) revealed patency of all other stented segments. Conclusion: P rimary stenting is an effective and reliable approach for complex plaq ues in stenoses. Patency of the arterial segment with a smooth lumen c an be created without the risk of acute complications such as distal e mbolization, dissection, or occlusion.