Clinical Experience of Iliac Artery Angioplasty with Stent Placement in Chronic Lower Limb Ischemia

ABSTRACT

PURPOSE: To analysis the results of iliac artery angioplasty with stent placement for the treatment of the chronic lower limb ischemic patients. METHODS: One hundred-six stenotic lesions of the iliac artery (87 male, 4 female, age 42~86) were treated with balloon angioplasty and stent placement from February 1995 through March 1999. All patients were symptomatic including claudication, resting pain and tissue loss. Indications for iliac artery stent placement were long segment stenotic lesion (>3 cm), dissection, failed balloon angioplasty. The pre-stenting and post-stenting clinical records, arteriograms, segmental limb pressure measurements (ankle-brachial and thigh-brachial indexes), and duplex scan were reviewed. The patients were follow up at 1, 3 and 6 month after stent placement and every 6 months thereafter. The Kaplan-Meier survival curve was used to calculate the cumulative patency rates. RESULTS: Patients were followed for up to 45 months (mean 16 months). The technical success rate was 104/106 (98%). The ankle-brachial index or thigh-brachial index improved from 0.64 in pre-stenting to 0.87 in post-stenting. The intraluminal pressure gradient decreased from 21.4 mmHg in pre-stenting to 2.5 mmHg in post-stenting. There was no major complication without 2 immediate stent occlusion. Cumulative primary patencies were 92%, 82%, 74% and 74% at 6, 12, 24 and 36 months. CONCLUSION: Excellent clinical results were achieved for the iliac artery stent placement for the chronic lower limb ischemic patients. Iliac stenting showed low morbidity and mortality rate, and was safe and effective for the treatment of iliac artery occlusive disease.