Intraarterial pressure gradients after randomized angioplasty or stenting of iliac artery lesions. Dutch Iliac Stent Trial Study Group.
OBJECTIVE
To determine initial technical results of percutaneous transluminal angioplasty (PTA) and stent procedures in the iliac artery, mean intraarterial pressure gradients were recorded before and after each procedure.


METHODS
We randomly assigned 213 patients with typical intermittent claudication to primary stent placement (n = 107) or primary PTA (n = 106), with subsequent stenting in the case of a residual mean pressure gradient of > 10 mmHg (n = 45). Eligibility criteria included angiographic iliac artery stenosis (> 50% diameter reduction) and/or a peak systolic velocity ratio > 2.5 on duplex examination. Mean intraarterial pressures were simultaneously recorded above and below the lesion, at rest and also during vasodilatation in the case of a resting gradient < or = 10 mmHg.


RESULTS
Pressure gradients in the primary stent group were 14.9 +/- 10.4 mmHg before and 2.9 +/- 3.5 mmHg after stenting. Pressure gradients in the primary PTA group were 17.3 +/- 11.3 mmHg pre-PTA, 4.2 +/- 5.4 mmHg post-PTA, and 2.5 +/- 2.8 mmHg after selective stenting. Compared with primary stent placement, PTA plus selective stent placement avoided application of a stent in 63% (86/137) of cases, resulting in a considerable cost saving.


CONCLUSIONS
Technical results of primary stenting and PTA plus selective stenting are similar in terms of residual pressure gradients.
Tetteroo
E
E
Department of Radiology, University Hospital Utrecht, The Netherlands.
Haaring
C
C
van der Graaf
Y
Y
van Schaik
J P
JP
van Engelen
A D
AD
Mali
W P
WP
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D001794:Blood Pressure; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007383:Intermittent Claudication / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015607:Stents; D014654:Vascular Patency; D014664:Vasodilation