Stenting of Extensive Occlusive Disease of the Iliac Segment inPatients with High CardiovascularRisk

Corresponding Author

Starodubtsev Vladimir, “Academician E.N. Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology”, Ministry for Public Health Care Russian Federation, Novosibirsk, 630055, Rechkunovsky str., 15, Russia, E-mail: starodub@mail.ru

Abstract

The purpose of our study was to evaluate immediate and long-term results of endovascular treatment in patients with a high risk of cardiovascular events and radiographic or angiographic evidence of extensive occlusive disease of iliac segment (TASC C, D).
Methods: We have included in this prospective, non-randomized study 166 patients with the diagnosis of atherosclerotic aortoiliac occlusive disease. All patients had a high risk of cardiovascular events and an objective evidence of TASC C, D iliac occlusive disease. One hundred and six iliac endovascular procedures were performed.
Results: Early (< 30 days) stent thrombosis was detected in 4 cases (2.4%). In 4 (2.4%) patients, there was an evidence of post-procedural distal thromboembolism. The mean follow-up was 38.8 months.
At the end of the 48-month follow-up period, thrombosis of the stented iliac segment was detected in 16 (9.6%) patients. In 14 (8.4%) patients, above-the-knee amputation was required. The cumulative primary stent patency at 1, 2, 3 and 4 years was 94,3 ± 2.3%; 86.3 ± 3,6%; 75,2 ± 5,3% and 68,9 ± 7,3% respectively. The limb salvage rate in our study at 1, 2 and 3 years was 96.2 ± 2,1%, 90 ± 3.3 and 86,3 ± 4.8%, respectively.
Conclusions: Iliac artery stenting is an effective minimally invasive treatment for high surgical rick patients with extensive occlusive iliac disease (TASC II type C and D), at least in the mid-term.