Long-term results 10 years after iliac arterial stent placement.
OBJECTIVE
To retrospectively evaluate results in 110 patients who had iliac arterial occlusive disease and were treated with stents before 1991.


METHODS
From 1987 to 1990, 110 patients (mean age, 57 years) with iliac arterial occlusive disease (Fontaine stage IIa, seven patients; IIb, 95 patients; III, four patients; IV, four patients) underwent implantation of a self-expanding metal stent. Stenoses (n = 66) were treated after failed angioplasty, and occlusions (n = 60) were treated with primary stent placement. Follow-up included angiography and/or color duplex ultrasonography and clinical examination with ankle-brachial index measurement. Patients lost to follow-up were interviewed by using dedicated questionnaires administered by telephone and/or mail. If a patient was deceased, relatives and attending doctors were interviewed.


RESULTS
The fate of 109 of the 110 patients was determined. Overall, 46 patients died: 18 within 5 years, 39 within 10 years, and seven after more than 10 years. The 5- and 10-year survival rates were 83% and 64%, respectively. Cardiovascular disease caused 23 deaths; malignant tumor caused 15. The cause of death remained unknown in five patients. Primary stent patency rates were 66% +/- 4.8 (standard error) after 5 years and 46% +/- 5.9 after 10 years; secondary patency rates were 79% +/- 4.2 after 5 years and 55% +/- 6.3 after 10 years (Kaplan-Meier test). Seventeen (16%) patients underwent surgical bypass of the aortoiliac arteries that involved the segment with the stent, 14 because of stent restenosis and three because of stenosis in other iliac arterial segments.


CONCLUSIONS
The main cause of death in patients with intermittent claudication was cardiac disease. Long-term patency of iliac arterial stents was moderate.
Department of Diagnostic Radiology, University of Technology of Aachen, Pauwelsstrasse 30, Germany.
Karl
K
Schürmann
Andreas
A
Mahnken
Julius
J
Meyer
Patrick
P
Haage
Khaled
K
Chalabi
Ilse
I
Peters
Rolf W
RW
Günther
Dierk
D
Vorwerk
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007383:Intermittent Claudication / Q000150:complications; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D014463:Ultrasonography; D014654:Vascular Patency