Result of Stent Insertion into Iliac Arterial System: Based on Transatlantic Inter-Society Consensus (TASC) Morphologic Stratification

Kim, Hoi Won; Choi, Soo Jin Na; Chung, Sang Young; Kim, Shin Gon; Yoon, Woong; Kim, Jae Kyu

Abstract

PURPOSE
The recommended treatments for iliac arterial occlusive disease are an endovascular procedure in TASC type A patients, but surgery in TASC type D patients. However, in TASC type B and C patients, more evidence is required to make any firm recommendations about the best treatments. This study aimed to evaluate the best treatments for patients classified using the TASC morphological stratification. METHOD: A retrospective review of the patients who had undergone stent insertion into iliac arterial occlusive lesions, between 1995 and 2004, at the Chonnam National University Hospital, was performed. All patients were also classified using the TASC morphologic stratification. The TASC type was determined from the initial peripheral angiography findings. Also, the stenosis-free patency was used as an objective end point to evaluate the hemodynamic outcome of stent insertion. RESULT: A total of 86 patients were included in the study. The number of patients classified as TASC types A, B, C and D were 1 25, 17, and 43, respectively. Stent insertion was successfully performed in all patients. The mean follow up period was 26 months. The 1-year stenosis-free patency rates were 94.4, 74.0, and 19.1% in TASC type B, C, and D, respectively. The 5-year patency rates were 50.4, 18.5, and 6.0% in TASC type B, C, and D, respectively.
CONCLUSION
The TASC morphological stratification was a useful prognostic factor in relation to the short and long-term iliac stent patency. For TASC types B and C, more evidence and experience of endovascular therapy are needed to confirm the best treatment. For TASC type D, surgical treatment is strongly recommended.