HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 2311030408v1 231/1/243    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Murphy, T. P. Articles by Kim, H. M. Search for Related Content PubMed PubMed Citation Articles by Murphy, T. P. Articles by Kim, H. M.

Aortoiliac Insufficiency: Long-term Experience with Stent Placement for Treatment¹

¹ From the Division of Vascular and Interventional Radiology, Department of Diagnostic Imaging (T.P.M., G.M.S.), and Department of Surgery (W.I.C., E.J.M., J.M.S.), Rhode Island Hospital, 593 Eddy St, Providence, RI 02903; Brown University Medical School, Brown Medical School, Providence, RI (N.S.A.); and Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor (H.M.K.). Received March 14, 2003; revision requested May 23; final revision received August 20; accepted September 4. Address correspondence to T.P.M.

PURPOSE: To establish and report the authors’ experience with the long-term outcomes of aortoiliac stent placement for treatment of chronic lower-extremity ischemia.

MATERIALS AND METHODS: Stents were placed in 505 arterial segment lesions in 365 patients who presented with symptoms of chronic leg ischemia between February 1992 and March 2001. The 505 treated lesions were 88 occlusions and 417 stenoses. Indications for stent placement were claudication in 312 (62%), rest pain in 107 (21%), ulcer in 67 (13%), and gangrene in 19 (4%) arterial segments. Patients were followed up for up to 105 months (mean, 33 months ± 27 [SD]).

RESULTS: Hemodynamic success was achieved in 484 (98%) of the 496 limbs for which postprocedural translesion pressure gradients were available. Mean ankle-brachial indexes improved from 0.53 ± 0.25 to 0.79 ± 0.23 (P < .001). Major complications were seen in 24 (7%) patients. Two patients (0.5%) died within 30 days after stent placement. Twenty (6%) of 355 patients underwent aortic or iliac bypass surgery during the follow-up period. Eight years after stent placement, primary patency was 74%; primary assisted patency, 81%; and secondary patency, 84%. Variables associated with better patency included stenosis (rather than occlusion), shorter lesion length, older age, and limb-threatening ischemia. At the last follow-up examination, 74% of the 466 limbs for which follow-up clinical status data were available were asymptomatic, 22% were associated with claudication, 3% were associated with rest pain, and 1% were associated with ischemic tissue loss. Five patients underwent amputation on the ipsilateral side after stent placement.

CONCLUSION: Findings from long-term experience with aortoiliac stent placement for treatment of chronic lower-extremity ischemia confirmed the procedure to be a durable, low-risk revascularization option.

© RSNA, 2004

Index terms: Arteries, stenosis or obstruction, 981.721, 984.721, 986.721 • Arteriosclerosis, 981.721, 984.721, 986.721 • Stents and prostheses, 981.1268, 984.1268, 986.1268

This article has been cited by other articles:

				M. J. Sharafuddin, J. J. Hoballah, T. F. Kresowik, and W. J. Sharp Kissing Stent Reconstruction of the Aortoiliac Bifurcation Perspectives in Vascular Surgery and Endovascular Therapy, March 1, 2008; 20(1): 50 - 60. [Abstract] [PDF]

				C. J. White and W. A. Gray Endovascular Therapies for Peripheral Arterial Disease: An Evidence-Based Review Circulation, November 6, 2007; 116(19): 2203 - 2215. [Abstract] [Full Text] [PDF]

				W. M. Klein, Y. v. d. Graaf, J. Seegers, J. H. Spithoven, E. Buskens, J. G. v. Baal, J. Buth, F. L. Moll, T. T. C. Overtoom, M. R. H. M. v. Sambeek, et al. Dutch Iliac Stent Trial: Long-term Results in Patients Randomized for Primary or Selective Stent Placement Radiology, December 21, 2005; (2005) 2382041053. [Abstract] [Full Text]