Long-term follow-up of the Palmaz stent for iliac occlusive disease.
BACKGROUND
Thirty-eight limbs with iliac occlusive disease were treated with Palmaz stents from 1987 through 1991.


METHODS
Indications for stent utilization included dissection induced by percutaneous transluminal balloon angioplasty (PTA) (10), restenosis after PTA (nine), post-PTA residual stenosis (nine), multiple stenoses or occlusion (five), and unfavorable location (five).


RESULTS
The ankle/brachial pressure index increased from 0.53 +/- 0.27 to 0.8 +/- 0.26 after stent deployment. The intraluminal pressure gradient decreased from 31.9 +/- 16.3 to 0.9 +/- 2.2 mm Hg after stent deployment. Complications included pseudoaneurysm (one), arteriovenous fistula (one), iliac perforation (one), groin hematoma (two), and occlusion (two). Follow-up arteriogram showed stenosis proximal or distal (n = 4) or within the stents (n = 4). These were treated with PTA or stents. Two patients required an aortobifemoral graft. Nine patients have died. Life table analysis showed a 1-, 3-, and 5-year primary and secondary cumulative patency of 87% +/- 5.9%, 74% +/- 8.2%, and 63% +/- 10% and 91% +/- 5.1%, 91% +/- 5.6%, and 86% +/- 7.6%, respectively.


CONCLUSIONS
Palmaz stents, often required to salvage a PTA failure, appear to maintain overall patency at a high level. However, intimal hyperplasia and the progression of atherosclerotic disease may result in a need for additional procedures to obtain this favorable outcome.
Cikrit
D F
DF
Department of Surgery, Indiana University Medical Center, Richard L. Roudebush Veterans Administration Hospital, Indianapolis 46202, USA.
Gustafson
P A
PA
Dalsing
M C
MC
Harris
V J
VJ
Lalka
S G
SG
Sawchuk
A P
AP
Trerotola
S O
SO
Snidow
J J
JJ
Johnson
M S
MS
Solooki
B
B
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012907:Smoking; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome