Results of iliac artery stent placement in patients younger than 50 years of age.
OBJECTIVE
To determine long-term outcome in patients 50 years of age or younger treated with iliac artery stent placement.


METHODS
The records of 412 patients who underwent iliac artery stent placement during a 62-month study period were reviewed retrospectively. Forty-two patients younger than age 50 (mean age = 45 y) at the time of stent placement were included in the study population. Presenting symptoms included claudication (47%), rest pain (17%), ulceration/tissue loss (31%), and blue toe syndrome (5%). Anatomic, hemodynamic, and clinical success rates of the stent placement procedure were assessed. Stent patency rates were calculated by life-table methods.


RESULTS
Fifty-nine iliac lesions were treated with stents; 62% of patients underwent treatment of a single lesion whereas 38% had multiple lesions treated. Thirty-one percent were treated after a failed angioplasty procedure and 69% were treated with stent placement primarily. After stent placement, 34 patients (82%) experienced symptomatic relief, although eight of these patients (19%) underwent a planned ipsilateral infrainguinal bypass procedure during the same hospitalization. During follow-up, five patients (12%) required a bypass procedure as a result of stent failure and two patients (5%) required below-knee amputation. Seven patients (17%) required endovascular stent revision, with none requiring additional surgery. At 1, 2, and 3 years, the primary patency rates were 86%, 72%, and 65%, and the secondary patency rates were 90%, 88%, and 88%, respectively.


CONCLUSIONS
Iliac stent placement successfully addresses the presenting symptoms of young patients with peripheral vascular disease and results in patency rates that are similar to those reported in a more general population. With appropriate postprocedural surveillance, restenosis can be addressed in many patients with use of endovascular techniques, limiting the need for surgical revision.
Siskin
Gary P
GP
Institute for Vascular Health and Disease, Albany Medical College, A-113, 47 New Scotland Avenue, Albany, New York 12208, USA. sisking@mail.amc.edu
Englander
Meridith
M
Roddy
Sean
S
Dowling
Kyran
K
Dolen
Eric G
EG
Quarfordt
Steven
S
Hughes
Terence
T
Mandato
Kenneth
K
D000328:Adult; D000367:Age Factors; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D007083:Iliac Artery; D007511:Ischemia / Q000628:therapy; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D017211:Treatment Failure; D014654:Vascular Patency