Quality improvement guidelines for endovascular treatment of iliac artery occlusive disease.
Endovascular therapy is the treatment of choice for type A and the preferred treatment for type B lesions. In selective patients, this type of treatment can be applied in type C and even type D lesions. Ipsilateral femoral, contralateral femoral, and brachial approach and both the intraluminal and subintimal space can be used for successful recanalization. The application of stents has improved the immediate hemodynamic and probably long-term clinical results of iliac percutaneous transluminal angioplasty. However, the superiority of primary or direct stenting over selective stenting has not been proven yet. The choice of stent type depends on lesion morphology and location but otherwise there is insufficient evidence to support the use of a particular stent design. There is insufficient evidence to justify routine use of covered stents. All patients should receive antiaggregant therapy following endovascular recanalization of iliac arteries. There is no consensus regarding prophylaxis with antibiotics in iliac recanalization procedures.
Tsetis
Dimitrios
D
Department of Radiology, University Hospital of Heraklion, Medical School of Crete, P.O. Box 1352, Stavrakia, 71110, Heraklion, Crete, Greece. tsetis@med.uoc.gr
Uberoi
Raman
R
D000800:Angioplasty, Balloon / Q000009:adverse effects; D001157:Arterial Occlusive Diseases / Q000145:classification / Q000628:therapy*; D006801:Humans; D007083:Iliac Artery; D010043:Outcome and Process Assessment, Health Care; D018579:Patient Selection; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D012008:Recurrence; D015607:Stents / Q000009:adverse effects; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods*
D010975:Platelet Aggregation Inhibitors