Long-Term Results of Primary Stenting for Long and Complex Iliac Artery Occlusions

Background: To evaluate safety, short and long-term graft patency, clinical success rates, and factors associated with patency, limb salvage and mortality after surgical reconstruction in patients younger than 50 years of age who had undergone unilateral iliac artery bypass surgery. Patients and methods: From January 2000 to January 2010, 65 consecutive reconstructive vascular operations were performed in 22 women and 43 men of age < 50 years with unilateral iliac atherosclerotic lesions and claudication or chronic limb ischemia. All patients were followed at 1, 3, 6, and 12 months after surgery and every 6 months thereafter. Results: There was in-hospital vascular graft thrombosis in four (6.1 %) patients. No in-hospital deaths occurred. Median follow-up was 49.6 ± 33 months. Primary patency rates at 1-, 3-, 5-, and 10-year were 92.2 %, 85.6 %, 73.6 %, and 56.5 %, respectively. Seven patients passed away during follow-up of which four patients due to coronary artery disease, two patients due to cerebrovascular disease and one patient due to malignancy. Limb salvage rate after 1-, 3-, 5-, and 10-year follow-up was 100 %, 100 %, 96.3 %, and 91.2 %, respectively. Cox regression analysis including age, sex, risk factors for vascular disease, indication for treatment, preoperative ABI, lesion length, graft diameter and type of pre-procedural lesion (stenosis/occlusion), showed that only age (beta - 0.281, expected beta 0.755, p = 0.007) and presence of diabetes mellitus during index surgery (beta - 1.292, expected beta 0.275, p = 0.026) were found to be significant predictors of diminishing graft patency during the follow-up. Presence of diabetes mellitus during index surgery (beta - 1.246, expected beta 0.291, p = 0.034) was the only variable predicting mortality. Conclusions: Surgical treatment for unilateral iliac lesions in patients with premature atherosclerosis is a safe procedure with a low operative risk and acceptable long-term results. Diabetes mellitus and age at index surgery are predictive for low graft patency. Presence of diabetes is associated with decreased long-term survival.

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Two Cases of Popliteal Cystic Adventitial Disease Treated with Primary Stenting: Long-Term Results

Annals of Vascular Surgery ◽

10.1016/j.avsg.2019.08.099 ◽

2020 ◽

Vol 63 ◽

pp. 460.e1-460.e4

Author(s):

Renato A. Mertens ◽

Michel Bergoeing ◽

Leopoldo Mariné ◽

Francisco Vargas ◽

Ignacio Torrealba ◽

...

Keyword(s):

Long Term Results ◽

Primary Stenting

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Endovascular Treatment of Common Iliac Artery Aneurysms Using the Bell-Bottom Technique: Long-term Results

Journal of Endovascular Therapy ◽

10.1583/10-3112.1 ◽

2010 ◽

Vol 17 (4) ◽

pp. 504-509 ◽

Cited By ~ 59

Author(s):

Giovanni Torsello ◽

Eva Schönefeld ◽

Nani Osada ◽

Martin Austermann ◽

Corinna Pennekamp ◽

...

Keyword(s):

Endovascular Treatment ◽

Iliac Artery ◽

Common Iliac Artery ◽

Long Term Results

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Primary Stenting of Focal Atherosclerotic Infrarenal Aortic Stenoses: Long-Term Results in 13 Patients and a Literature Review

CardioVascular and Interventional Radiology ◽

10.1007/s00270-003-2724-8 ◽

2004 ◽

Vol 27 (2) ◽

pp. 121-128 ◽

Cited By ~ 23

Author(s):

Saim Yilmaz ◽

Timur Sindel ◽

Arif Yegin ◽

Abdullah Erdoğan ◽

Ersin Lüleci

Keyword(s):

Literature Review ◽

Long Term Results ◽

Primary Stenting

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Predictors of Long-Term Results After Treatment of Iliac Artery Obliteration by Transluminal Angioplasty and Stent Deployment

CardioVascular and Interventional Radiology ◽

10.1007/s00270-002-1877-1 ◽

2002 ◽

Vol 25 (5) ◽

pp. 397-402 ◽

Cited By ~ 34

Author(s):

M.A. Funovics ◽

B. Lackner ◽

M. Cejna ◽

P. Peloschek ◽

J. Sailer ◽

...

Keyword(s):

Iliac Artery ◽

Transluminal Angioplasty ◽

Long Term Results ◽

Stent Deployment

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Percutaneous Treatment in Iliac Artery Occlusion: Long-Term Results

CardioVascular and Interventional Radiology ◽

10.1007/s00270-008-9386-5 ◽

2008 ◽

Vol 31 (6) ◽

pp. 1069-1076 ◽

Cited By ~ 44

Author(s):

Roberto Gandini ◽

Sebastiano Fabiano ◽

Marcello Chiocchi ◽

Roberto Chiappa ◽

Giovanni Simonetti

Keyword(s):

Iliac Artery ◽

Percutaneous Treatment ◽

Artery Occlusion ◽

Long Term Results ◽

Iliac Artery Occlusion

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Long-term Results After Recanalisation of Chronic Iliac Artery Occlusions by Combined Catheter Therapy Without Stent Placement

European Journal of Vascular and Endovascular Surgery ◽

10.1053/ejvs.1999.0945 ◽

1999 ◽

Vol 18 (6) ◽

pp. 499-505 ◽

Cited By ~ 29

Author(s):

A.J Leu ◽

E Schneider ◽

C.R Canova ◽

U Hoffmann

Keyword(s):

Iliac Artery ◽

Stent Placement ◽

Long Term Results

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Recent Advances in Endovascular Treatment of Aortoiliac Occlusive Disease

Medicina ◽

10.3390/medicina48120096 ◽

2013 ◽

Vol 48 (12) ◽

pp. 96

Author(s):

Žana Kavaliauskienė ◽

Aleksandras Antuševas ◽

Rytis Kaupas ◽

Nerijus Aleksynas

Keyword(s):

Iliac Artery ◽

Clinical Success ◽

Early Mortality ◽

Occlusive Disease ◽

Long Term Results ◽

Secondary Patency ◽

Complication Rates ◽

Technical Success ◽

Aortoiliac Occlusive Disease

The rate of endovascular interventions for iliac occlusive lesions is continuously growing. The evolution of the technology supporting these therapeutic measures improves the results of these interventions. We performed a review of the literature to report and appreciate short- and long-term results of endovascular stenting of iliac artery occlusive lesions. The Medline database was searched to identify all the studies reporting iliac artery stenting for aortoiliac occlusive disease (Trans Atlantic Inter-Society Consensus [TASC] type A, B, C, and D) from January 2006 to July 2012. The outcomes were technical success, long-term primary and secondary patency rates, early mortality, and complications. Technical success was achieved in 91% to 99% of patients as reported in all the analyzed articles. Early mortality was described in 5 studies and ranged from 0.7% to 3.6%. The most common complications were access site hematomas, distal embolization, pseudoaneurysms, and iliac artery ruptures. The complications were most often treated conservatively or using percutaneous techniques. The 5-year primary and secondary patency rates ranged from 63% to 88% and 86% to 93%, respectively; and the 10-year primary patency rates ranged from 68% to 83%. In this article, combined percutaneous endovascular iliac stenting and infrainguinal surgical reconstructions and new techniques in the treatment of iliac stent restenosis are discussed. Iliac stenting is a feasible, safe, and effective method for the treatment of iliac occlusive disease. Initial technical and clinical success rates are high; early mortality and complication rates are low. Longterm patency is comparable with that after bypass surgery.

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Remote Iliac Artery Endarterectomy: A Case Series and Systematic Review

Journal of Endovascular Therapy ◽

10.1177/1526602817749620 ◽

2018 ◽

Vol 25 (1) ◽

pp. 140-149 ◽

Cited By ~ 1

Author(s):

Joost A. Bekken ◽

Sanne W. de Boer ◽

Rogier van der Sluijs ◽

Hidde Jongsma ◽

Jean-Paul P. M. de Vries ◽

...

Keyword(s):

Systematic Review ◽

Treatment Option ◽

Iliac Artery ◽

English Language ◽

Case Series ◽

External Iliac Artery ◽

Primary Patency ◽

Long Term Results ◽

Secondary Patency

Purpose: To evaluate the long-term results of remote iliac artery endarterectomy (RIAE) in 2 vascular referral centers and review existing literature. Methods: A retrospective analysis was conducted of 109 consecutive patients (mean age 64.2±10.7 years; 72 men) who underwent 113 RIAE procedures for lower limb ischemia from January 2004 to August 2015 at 2 vascular centers. The majority of limbs (82, 72.6%) had TASC II D lesions (31 TASC II C). Primary outcome measures were primary, assisted primary, and secondary patency. A comprehensive literature search was performed in the PubMed and EMBASE databases to identify all English-language studies published after 1990 reporting the results of RIAE. Results: Technical success was achieved in 95 (84.1%) of the 113 procedures. The complication rate was 13.7%, and 30-day mortality was 0%. At 5 years, primary patency was 78.2%, assisted primary patency was 83.4%, and secondary patency was 86.7%. Hemodynamic success was obtained in 91.7% of patients, and clinical improvement was observed in 95.2%. Freedom from major amputation was 94.7% at 5 years. The systematic review comprised 6 studies including 419 RIAEs, and pooled data showed results similar to the current study. Conclusion: For external iliac artery occlusions extending into the common femoral artery, RIAE appears to be a valuable hybrid treatment option. It combines acceptable morbidity and low mortality with good long-term patency. It has some advantages over an open surgical iliofemoral bypass or complete endovascular revascularization and could be the best treatment option in selected cases.

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