Endovascular treatment for long segment iliac artery occlusion involving the iliac artery opening.

OBJECTIVE: This retrospective nonrandomized study investigated the outcomes of endovascular therapy for long-segment iliac artery occlusion involving the iliac artery opening. METHODS: During a 5-year period (from Mar 2012 to Mar 2017), 32 patients (two women and 30 men; mean age, 69.0 years; range, 51-90 years) received endovascular therapy, with or without catheter-directed thrombolysis (CDT), for long-segment iliac artery occlusion (mean lesion length, 129.8 mm; range, 74.7-189.3 mm). RESULTS: The technical success rate was 90.6% (29 of 32). The major complication rate was 3.5%, but no in-hospital mortality was recorded. The access site complication rate was 10.3%. The clinical symptoms of 29 patients were significantly improved. All 29 patients were followed up for 6-40 months, with an average of 16.7 ± 10.9 months. The primary patency rates were 96.6 ± 3.4% at 6 months, 86.6 ± 7.3% at 12 months, 79.4 ± 9.6% at 24 months, and 66.2 ± 14.5% at 36 months. CONCLUSIONS: Depending on the characteristics of the disease, endovascular treatment with an individualized, rational choice of approach and with fine-tuning of the operation is a safe and effective treatment for long-term iliac artery occlusion involving the opening of the iliac arteries. Customization of the treatment is also the key to a successful operation and to ensuring good postoperative efficacy.