Aortoiliac stent placement in patients treated for intermittent claudication.
OBJECTIVE
To assess the results of iliac artery stent placement for the treatment of patients with intermittent claudication.


METHODS
Lesions in 90 iliac arteries were treated in 65 patients with 111 Wallstents and 21 Palmaz stents. Stents were placed for symptoms of intermittent claudication classified as grade I, categories 1-3 by the SVS/ISCVS/SCVIR reporting standards. Sixty-two stenosed arteries and 28 chronically occluded arteries were treated. Patients were followed for up to 57.1 months (mean, 17.4 months +/- 14.9).


RESULTS
Technical success was achieved in 87 of 90 iliac limbs (97%), with major complications in seven of 65 patients (11%). The 30-day mortality was zero. Mean pressure gradients across stenoses improved from 14.7 mm Hg +/- 9.8 to 1.4 mm Hg +/- 1.4 (P < .001). Ankle-brachial indices improved from 0.62 +/- 0.21 to 0.90 +/- 0.18 (P < .001). With use of the Rutherford criteria, 84% demonstrated +2 or +3 improvement. The cumulative patency rates were 77%, 71%, 62%, and 62% at 1, 2, 3, and 4 years (standard error [SE] < 10%). Continued clinical and noninvasive test benefit was present in 80%, 80%, 73%, and 73% at 1, 2, 3, and 4 years, respectively (SE < 10%).


CONCLUSIONS
Significant hemodynamic improvement can be achieved by percutaneous stent placement, with excellent clinical results. Observed mortality in this series was zero, but major complications, requiring modification of the treatment plan, were seen in 11% of patients. Clinical results were better than suggested using current accepting reporting standards for "patency."
Murphy
T P
TP
Department of Diagnostic Imaging, Rhode Island Hospital, Brown University School of Medicine, Providence 02903, USA.
Khwaja
A A
AA
Webb
M S
MS
D001012:Aorta, Abdominal; D001018:Aortic Diseases / Q000628:therapy*; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery; D007383:Intermittent Claudication / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D014654:Vascular Patency / Q000502:physiology