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Stent-supported recanalization of chronic iliac artery occlusions

Item Type:Article
Title:Stent-supported recanalization of chronic iliac artery occlusions
Creators Name:Scheinert, D. and Schroeder, M. and Ludwig, J. and Braeunlich, S. and Moeckel, M. and Flachskampf, F.A. and Balzer, J.O. and Biamino, G.
Abstract:PURPOSE: Iliac artery occlusions that are more than a few centimeters in length are normally treated with surgical bypass grafting. The aim of this study was to evaluate the results of primary stent implantation after Excimer laser-assisted recanalization of iliac artery occlusions. SUBJECTS AND METHODS: We studied 212 consecutive patients with chronic unilateral iliac artery occlusions (mean [+/- SD] length 8.9 +/- 3.9 cm) who were treated with Excimer laser-assisted recanalization and stent implantation. Based on the criteria of the Society of Cardiovascular and Interventional Radiology, lesions were graded as class III occlusions (<5 cm) in 46 patients and as class IV (> or =5 cm) in 166 patients. A total of 527 stents (Palmaz stent, 346; Wallstent, 94; Strecker stent, 38; covered stents, 49) were implanted. RESULTS: Technical success was achieved in 190 (90%) patients. There was a clinical improvement of three grades in 112 (53%) patients and of two grades in 67 (32%) patients. The rate of major complications was 1.4%, which included arterial rupture (1) and embolic events (2). Primary patency rates were 84% at 1 year, 81% at 2 years, 78% at 3 years, and 76% at 4 years. Secondary patency rates were 88% at 1 year, 88% at 2 years, 86% at 3 years, and 85% at 4 years. CONCLUSION: Stent-supported angioplasty is an effective treatment for iliac artery occlusions, with less morbidity and mortality than is associated with surgery. However, reported long-term patency rates after bypass surgery are greater than those we observed with interventional treatment. The value of primary stenting as compared with angioplasty alone should be evaluated in a randomized trial.
Keywords:Arterial Occlusive Diseases, Chronic Disease, Combined Modality Therapy, Disease-Free Survival, Follow-Up Studies, Iliac Artery, Lasers, Recurrence, Risk Factors, Stents
Source:American Journal of Medicine
Page Range:708-715
Date:15 June 2001
Official Publication:https://doi.org/10.1016/S0002-9343(01)00727-6
PubMed:View item in PubMed

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