Percutaneous recanalization of iliac artery occlusions: results of a prospective study.
OBJECTIVE
To evaluate the long-term results of recanalization of occluded iliac arteries with local low-dose thrombolysis, angioplasty, and, if necessary, stent implantation.


METHODS
Forty-seven patients with acute or chronic occlusions of the common or external iliac artery, or both, underwent local low-dose thrombolysis (n = 47), percutaneous transluminal angioplasty (PTA) (with balloon dilation [n = 43] and rotational angioplasty [n = 30] in the patients in whom a retrograde recanalization was performed), and, if needed, intravascular stent placement (n = 18). Follow-up lasted 3-53 (mean, 21) months.


RESULTS
The primary recanalization rate was 98% (46 of 47). The mean ankle-brachial index increased from 0.33 to 0.81 within 14 days after treatment and was 0.76 at the most recent follow-up. Two early (< 14 days) and two late reocclusions (after 24 and 30 months) occurred; one restenosis detected with duplex sonography and angiography was observed after 19 months.


CONCLUSIONS
This therapy represents a true alternative to vascular surgery and a first-line treatment for acute or chronically occluded iliac arteries.
Blum
U
U
Department of Diagnostic Radiology, University Hospital Freiburg, Germany.
Gabelmann
A
A
Redecker
M
M
Nöldge
G
G
Dornberg
W
W
Grosser
G
G
Heiss
W
W
Langer
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000628:therapy*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy; D004617:Embolism / Q000209:etiology; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D013193:Stainless Steel; D015607:Stents / Q000009:adverse effects; D015912:Thrombolytic Therapy / Q000009:adverse effects; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use; D014463:Ultrasonography; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use
D013193:Stainless Steel; D006493:Heparin; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator