Percutaneous Intravascular Metallic Stent Placement in Chronic Iliac Artery Stenoses

Sohn, Min Jee; Sung, Kyu Bo; Shin, Byung Suk; Lim, Soo Mee; Kim, Bong Soo; Song, Ho Young; Kwon, Tae Won; Yoon, Hyun Ki

Abstract

PURPOSE: To determine the long-term patency of percutaneous intravascular metallic stent placement in patients with chronic iliac artery stenosis.
MATERIALS AND METHODS
Intravascular metallic stents were placed percutaneously in 41 limbs of 38 patients with chronic iliac artery stenosis who presented with intermittent claudication in 40 limbs and gangrene in the other. Preoperative angiography showed that complete occlusion occurred in one limb, and luminal stenosis of over 50% in 34 and of less than 50% in six. The mean length of stenoses was 3.1 (range, 1 -8) cm, and in all cases the systolic pressure gradient was over 10 (range, 12 -100, mean, 43) mmHg. Stent placement was indicated by failed balloon angioplasty in 35 limbs, primary stenting in five, and restenosis after balloon angioplasty in one. Technical and clinical success were evaluated in terms of immediate results and stent patency over a period of 1 -49 (mean, 19) months (Kaplan-Meier method).
RESULTS
Stent placement was successful in all cases in which residual stenosis was less than 10% and systolic pressure gradient less than 2 mmHg. One to three days after the procedure, clinical symptoms had improved in 40 limbs and ABI (n=23) had increased from 0.64 +/-0.20 to 0.92 +/-0.17. Follow-up studies demonstrated patency rates of 94.1% at 6 months, 90.7% at 1 year, 86.6% at 2 years, and 86.6% at 4 years.
CONCLUSION
Our results showed that in patients with chronic iliac artery stenosis, percutaneous intravascular metallic stent placement led to patency rates which were similar over a period of between six months and four years.