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Long-term Results 10 Years after Iliac Arterial Stent Placement¹

¹ From the Departments of Diagnostic Radiology (K.S., A.M., J.M., P.H., R.W.G.) and Cardiovascular and Thoracic Surgery (K.C., I.P.), University of Technology of Aachen, Pauwelsstrasse 30, D-52057 Aachen, Germany; and the Department of Diagnostic and Interventional Radiology, Clinic of Ingolstadt, Germany (D.V.). Received June 26, 2001; revision requested August 3; revision received November 16; accepted January 18, 2002. Address correspondence to K.S. (e-mail: schuerm@rad.rwth-aachen.de).

View larger version (45K): [in a new window]   Figure 1. Graph shows cumulative survival rates in 110 patients treated with iliac arterial stent placement. During the 10-year follow-up period, only one patient (in the 1st year) was lost to follow-up. After 10 years, there was rapid loss of patients to follow-up. = deaths. Numbers indicate numbers of patients at risk.

View larger version (39K): [in a new window]   Figure 2. Graph shows primary and secondary patency rates in 126 iliac lesions treated with stent placement. Data constituting the basis of this Figure are given in Table 2.

View larger version (179K): [in a new window]   Figure 3a. Bilateral occlusions of the external iliac arteries in a 49-year-old man with a Fontaine stage IIb lesion. (a) Posteroanterior intraarterial angiogram obtained during recanalization of the right iliac artery in October 1989 shows that both occlusions (arrows) are more than 5 cm long. The occlusion on the right side has already been passed by using a guide wire (arrowhead). The left external iliac artery was recanalized in November 1989. (b) Posteroanterior follow-up angiogram obtained in April 1991 shows patent iliac arteries. On the right side, two overlapping 10-mm stents (arrows) are well seen. On the left side, stents are not visible. (c) Right anterior oblique intraarterial angiogram obtained 8 years after a in October 1997 shows no claudication; both external iliac arteries (arrows) are patent. (d) In May 2001 claudication (Fontaine stage IIb) recurred in the right leg. There were no symptoms in the left leg. After diagnosis of restenosis by using color duplex US, the posteroanterior intraarterial angiogram shows a short restenosis of about 70% (arrow) at the distal end of the stent in the right external iliac artery. (e) Posteroanterior intraarterial angiogram shows patency after PTA with an 8-mm balloon.

View larger version (181K): [in a new window]   Figure 3b. Bilateral occlusions of the external iliac arteries in a 49-year-old man with a Fontaine stage IIb lesion. (a) Posteroanterior intraarterial angiogram obtained during recanalization of the right iliac artery in October 1989 shows that both occlusions (arrows) are more than 5 cm long. The occlusion on the right side has already been passed by using a guide wire (arrowhead). The left external iliac artery was recanalized in November 1989. (b) Posteroanterior follow-up angiogram obtained in April 1991 shows patent iliac arteries. On the right side, two overlapping 10-mm stents (arrows) are well seen. On the left side, stents are not visible. (c) Right anterior oblique intraarterial angiogram obtained 8 years after a in October 1997 shows no claudication; both external iliac arteries (arrows) are patent. (d) In May 2001 claudication (Fontaine stage IIb) recurred in the right leg. There were no symptoms in the left leg. After diagnosis of restenosis by using color duplex US, the posteroanterior intraarterial angiogram shows a short restenosis of about 70% (arrow) at the distal end of the stent in the right external iliac artery. (e) Posteroanterior intraarterial angiogram shows patency after PTA with an 8-mm balloon.

View larger version (135K): [in a new window]   Figure 3c. Bilateral occlusions of the external iliac arteries in a 49-year-old man with a Fontaine stage IIb lesion. (a) Posteroanterior intraarterial angiogram obtained during recanalization of the right iliac artery in October 1989 shows that both occlusions (arrows) are more than 5 cm long. The occlusion on the right side has already been passed by using a guide wire (arrowhead). The left external iliac artery was recanalized in November 1989. (b) Posteroanterior follow-up angiogram obtained in April 1991 shows patent iliac arteries. On the right side, two overlapping 10-mm stents (arrows) are well seen. On the left side, stents are not visible. (c) Right anterior oblique intraarterial angiogram obtained 8 years after a in October 1997 shows no claudication; both external iliac arteries (arrows) are patent. (d) In May 2001 claudication (Fontaine stage IIb) recurred in the right leg. There were no symptoms in the left leg. After diagnosis of restenosis by using color duplex US, the posteroanterior intraarterial angiogram shows a short restenosis of about 70% (arrow) at the distal end of the stent in the right external iliac artery. (e) Posteroanterior intraarterial angiogram shows patency after PTA with an 8-mm balloon.

View larger version (139K): [in a new window]   Figure 3d. Bilateral occlusions of the external iliac arteries in a 49-year-old man with a Fontaine stage IIb lesion. (a) Posteroanterior intraarterial angiogram obtained during recanalization of the right iliac artery in October 1989 shows that both occlusions (arrows) are more than 5 cm long. The occlusion on the right side has already been passed by using a guide wire (arrowhead). The left external iliac artery was recanalized in November 1989. (b) Posteroanterior follow-up angiogram obtained in April 1991 shows patent iliac arteries. On the right side, two overlapping 10-mm stents (arrows) are well seen. On the left side, stents are not visible. (c) Right anterior oblique intraarterial angiogram obtained 8 years after a in October 1997 shows no claudication; both external iliac arteries (arrows) are patent. (d) In May 2001 claudication (Fontaine stage IIb) recurred in the right leg. There were no symptoms in the left leg. After diagnosis of restenosis by using color duplex US, the posteroanterior intraarterial angiogram shows a short restenosis of about 70% (arrow) at the distal end of the stent in the right external iliac artery. (e) Posteroanterior intraarterial angiogram shows patency after PTA with an 8-mm balloon.

View larger version (132K): [in a new window]   Figure 3e. Bilateral occlusions of the external iliac arteries in a 49-year-old man with a Fontaine stage IIb lesion. (a) Posteroanterior intraarterial angiogram obtained during recanalization of the right iliac artery in October 1989 shows that both occlusions (arrows) are more than 5 cm long. The occlusion on the right side has already been passed by using a guide wire (arrowhead). The left external iliac artery was recanalized in November 1989. (b) Posteroanterior follow-up angiogram obtained in April 1991 shows patent iliac arteries. On the right side, two overlapping 10-mm stents (arrows) are well seen. On the left side, stents are not visible. (c) Right anterior oblique intraarterial angiogram obtained 8 years after a in October 1997 shows no claudication; both external iliac arteries (arrows) are patent. (d) In May 2001 claudication (Fontaine stage IIb) recurred in the right leg. There were no symptoms in the left leg. After diagnosis of restenosis by using color duplex US, the posteroanterior intraarterial angiogram shows a short restenosis of about 70% (arrow) at the distal end of the stent in the right external iliac artery. (e) Posteroanterior intraarterial angiogram shows patency after PTA with an 8-mm balloon.