Percutaneous placement of stents in chronic iliac and aortic occlusive disease

Abstract

Objectives: to evaluate the long-term results of stenting in iliac and aortic occlusive disease and identify factors predicting clinical outcome. Design: retrospective study. Materials and methods: 82 patients (87 limbs) with stenoses (n = 63) and occlusions (n = 24) in the aortoiliac segment were treated with stents. 81 lesions involved the iliac arteries, 3 the infrarenal aorta and 3 the aortic bifurcation. Primary stenting was preformed in 57 limbs (complex stenotic lesions and occlusions). Stents were placed following failed PTA in 30 limbs. Median follow-up was 13.2 months (1-66 months). Results: technical success was 99% and clinical success 89%. Cumulative primary and secondary patency of stented iliac atherosclerotic lesions at 1 and 3 years was 75 and 61%, and 83 and 75% respectively. The factors predicting outcome of primary patency identified in Cox multivariate analysis were ankle-brachial index (ABI) prior stenting (p = 0.03) and length of the lesion (p = 0.007). Major non-fatal complication occurred in 7.4% of the patients and there were no deaths attributed to the treatment. The 30-day mortality was 3.7%. Conclusion: stenting of complex aortoiliac stenoses and chronic occlusions is a safe and effective treatment modality. Long lesions and lower pre-procedure ABIs were found to negatively influence outcome.