PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY AND PRIMARY STENTING OF THE ILIAC ARTERIES IN 288 PATIENTS

Citation
Tm. Sullivan et al., PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY AND PRIMARY STENTING OF THE ILIAC ARTERIES IN 288 PATIENTS, Journal of vascular surgery, 25(5), 1997, pp. 829-838
Citations number
25
Categorie Soggetti
Surgery,"Peripheal Vascular Diseas
Journal title
ISSN journal
07415214
Volume
25
Issue
5
Year of publication
1997
Pages
829 - 838
Database
ISI
SICI code
0741-5214(1997)25:5<829:PTAAPS>2.0.ZU;2-P
Abstract
Purpose: This study reports the initial and late results of percutaneo us transluminal angioplasty (PTA) and intravascular stenting for ather osclerotic occlusive disease of the iliac arteries. Methods: The prepr ocedural and postprocedural clinical records, arteriograms, segmental limb pressure measurements (ankle-brachial [ABI] and thigh-brachial [T BI] indexes), and pulse volume recordings of 288 patients who underwen t PTA and primary stenting of the common iliac (354, 69.4%) and extern al iliac (156, 30.6%) arteries were reviewed. Initial and late clinica l, hemodynamic, and angiographic success were assessed by objective cr iteria. Data on patients who underwent unsuccessful attempts at iliac stent placement are unavailable; results are not reported on an intent -to-treat basis. Results: Clinical follow-up data (mean, 11.9 months) are available for 268 of 288 patients (93.1%) and for 394 of 424 limbs (92.9%). The initial success rates, as determined by TBI, ABI, and cl inical limb status, were 90.2%, 87.8%, and 74.6%, respectively. The Ka plan-Meier estimates of angiographic patency (101 arteries) were 96%, 81%, and 73% at 6, 12, and 24 months. Cumulative patency rates were 84 %, 76%, and 57% on the basis of TBI, ABI, and clinical limb status at 24 months. Factors associated with initial success included the need f or multiple stents (p = 0.0001), a higher degree of initial stenosis ( p 0.0001), lower severity of baseline ischemia (p = 0.007), younger ag e (p = 0.0015), and the preprocedural patency of the ipsilateral super ficial femoral artery (p = 0.002). A higher degree of initial stenosis (p < 0.001) and superficial femoral artery patency (p < 0.004) were a lso associated with late success. Conclusions: PTA and stenting of the iliac arteries is associated with reasonable angiographic, hemodynami c, and clinical success. The outcome is favorably affected by higher i nitial severity of stenosis and greater extent of disease, lower sever ity of baseline ischemia, younger age, and by patency of the ipsilater al superficial femoral artery.