Transfemoral treatment for iliac occlusive disease with endoluminal stent-grafts.
OBJECTIVE
Percutaneous treatment of iliac artery occlusive disease has replaced open vascular reconstruction for several indications. A balloon angioplasty with or without stent is not an option in the presence of infrainguinal extension of the disease. The authors describe a technique that allows the construction of an aorto- or iliofemoral graft through a single groin incision, using a 4 mm PTFE graft, anchoring it proximally with a Palmaz stent and dilating both to the desired diameter.


METHODS
Retrospective non-randomised study.


METHODS
Nineteen procedures were performed in 16 patients mainly because of ischaemic rest pain, often with trophic skin changes or minor gangrene. Three patients had a bilateral procedure. Twelve patients had one or more associated procedures: 10 distal bypasses, one thrombectomy, one reimplantation of a distal bypass on the iliofemoral graft, one contralateral profundaplasty and two stents of the contralateral common iliac artery.


RESULTS
Two patients died, one of small bowel ischaemia and the other of a myocardial infarction. During the mean follow-up of 8.8 months, two graft thromboses occurred. In another patient bilateral stenting of a residual stenosis was necessary.


CONCLUSIONS
Our experience shows that the reported technique is feasible. Whether the procedure is truly "less invasive" and the long-term results acceptable remains to be shown.
Lacroix
H
H
Department of Vascular Surgery, University Hospital Gasthuisberg, Leuven, Belgium.
Stockx
L
L
Wilms
G
G
Nevelsteen
A
A
D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D007083:Iliac Artery; D008297:Male; D011138:Polytetrafluoroethylene; D012189:Retrospective Studies; D015607:Stents
D011138:Polytetrafluoroethylene