Purpose: To determine the success rate and 24-month follow-up results of pr
imary stent implantation for reconstruction of unilateral short iliac occlu
sion involving the aortic bifurcation.
Material and Methods: In 90 patients attempts of percutaneous transluminal
recanalization of a short unilateral occlusion of the iliac arteries were p
erformed. In 72/90 patients, the treatment was successful. Stent implantati
on was performed after recanalization in all 72 patients. Pre-interventiona
l angiography of successfully treated patients showed unilateral occlusions
and contralateral stenosis in 34/72 patients. In 38/72 patients unilateral
occlusion without contralateral stenosis was diagnosed. The recanalization
of the common iliac artery obstructions were performed with a guidewire an
d excimer laser angioplasty. Totally 152 stents were used for the treatment
of iliac occlusion. Standardized treadmill testing and color-coded Doppler
ultrasound were performed before treatment and during the follow-up.
Results: In all patients, stents were placed successfully; 5 major and 7 mi
nor complications were observed. A clinical improvement of + 2 to + 3 accor
ding to the American Heart Association criteria was observed in 62 and 10 p
atients, respectively. Angiographic control was performed after 1-30 months
. The primary angiographic patency rate was 83.1%. Angiography revealed sig
nificant restenoses in 4 patients successfully treated with transluminal an
gioplasty, and re-occlusion in 6 patients which were referred to surgery. T
he patency rate after 24 months was 90.0%.
Conclusion: Primary stent implantation is an effective treatment for short
iliac obstructions and represents a true endovascular alternative to surger
y.