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Radiology, Vol 197, 479-483, Copyright © 1995 by Radiological Society of North America

ARTICLES

Late reobstruction in iliac arterial stents: percutaneous treatment

D Vorwerk, RW Guenther, K Schurmann and G Wendt
Department of Diagnostic Radiology, Technical University of Aachen, Germany.

PURPOSE: To retrospectively analyze in a nonrandomized fashion the efficacy of percutaneous reintervention in obstructed iliac stents. MATERIALS AND METHODS: In 21 symptomatic patients with iliac lesions, 26 reinterventions (16 for stent occlusion and 10 for stent stenosis) were performed. Restenoses were treated with balloon dilation and either atherectomy or stent placement. Reocclusions were treated with atherectomy or aspiration thrombectomy and then recanalization with balloon dilation and selective stent placement. RESULTS: Balloon angioplasty for stent stenosis was effective in all but one patient. Recanalization was successful in 14 of 16 patients with stent occlusion. The mean period of patency after reintervention was 18 months +/- 15. Cumulative stent stenosis patency after reintervention was 87% after 1 year. Stent occlusion patency was 57%. Recurrent stent obstruction occurred in eight of 24 (33%) patients with successful primary interventions. CONCLUSION: Percutaneous reintervention for both stent stenosis and occlusion is feasible with a moderate complication rate and may be attempted before surgery.


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