Stent placement in short unilateral iliac occlusion - Technique and 24-month results

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.