title: Heavily calcified occlusive lesions of the iliac artery: long-term patency and CT findings after stent placement.
abstract: OBJECTIVE
  To evaluate the influence of heavy calcification on iliac arterial stent expansion and patency and to define the spatial relationship between the stent and heavy calcifications on computed tomography (CT).
  
  
  METHODS
  Thirteen patients (11 men, two women; mean age, 66.5 y) with 14 heavily calcified iliac arteries received primary stent treatment between 1998 and 2008. Anatomic success was defined by less than 30% residual stenosis on final follow-up CT angiography. Hemodynamic success was defined as an increase in the ankle-brachial index (ABI) of at least 0.15 versus baseline. Clinical success was defined by achievement of clinical improvement of at least one clinical category. Stent patency; anatomic, hemodynamic, and clinical success rate; morphology of heavy calcifications; calcium score; and stent geometry were evaluated.
  
  
  RESULTS
  Stents were successfully inserted in all cases. During a mean follow-up of 33.6 months (range, 8-55 mo), the stent-implanted iliac arteries remained anatomically patent in all patients on final follow-up. The anatomic, hemodynamic, and clinical success rates were 28.6%, 60%, and 78.6%, respectively. Mean ABIs were 0.68 ± 0.22 before the procedure and 0.91 ± 0.23 after the procedure (P = .021). Mean luminal stenosis measurements were 77.9% before the procedure and 47.9% after the procedure (P = .008).
  
  
  CONCLUSIONS
  Iliac stents in heavily calcified lesions showed hemodynamically significant residual stenosis in a considerable number of cases. However, stent patency was not affected even with incomplete expansion of the stent.
authors.affiliation: Department of Radiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-Gu, Seoul 135-710, Korea.
authors.forename: Il Soo
authors.initials: IS
authors.lastname: Chang
authors.forename: Kwang Bo
authors.initials: KB
authors.lastname: Park
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Do
authors.forename: Hong Suk
authors.initials: HS
authors.lastname: Park
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Shin
authors.forename: Sung Ki
authors.initials: SK
authors.lastname: Cho
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Choo
authors.forename: In-Wook
authors.initials: IW
authors.lastname: Choo
authors.forename: Dong-Ik
authors.initials: DI
authors.lastname: Kim
authors.forename: Young Wook
authors.initials: YW
authors.lastname: Kim
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency