title: Clinical outcomes with contemporary endovascular therapy of iliac artery occlusive disease.
abstract: OBJECTIVE
  We sought to evaluate the clinical outcomes of a consecutive series of patients treated for iliac artery occlusive disease (IAOD) using contemporary endovascular technology and techniques.
  
  
  BACKGROUND
  As an increasingly complex spectrum of IAOD is treated using endovascular revascularization, there is a need to examine the rates of acute procedural success, complications, and patency to validate the role of an endovascular-first approach to revascularization in contemporary practice.
  
  
  METHODS
  All patients with IAOD who were treated using endovascular therapy between September 2005 and September 2010 were identified from a prospectively collected database. Baseline patient characteristics, anatomic details, procedural data, and clinical outcomes were assessed retrospectively. Patency and mortality rates were estimated with the Kaplan-Meier method.
  
  
  RESULTS
  A total 59 patients underwent 62 procedures. Trans-Atlantic Inter-Society Consensus (TASC) II types B, C, and D disease accounted for 59%, 7%, and 37% of patients, respectively. The procedure was technically successful in 60 of 62 cases (97%) with no procedure-related mortality. Major complications occurred in five procedures (8%). The mean (±standard deviation) duration of follow-up was 2.3 ± 1.4 years. In patients with a successful revascularization, primary and secondary patency rates were 86% and 94% at 1 year, and 77% and 91% at 2 years, respectively. The TASC II classification of disease did not predict the rate of acute technical success or medium-term patency rates.
  
  
  CONCLUSIONS
  The acute and medium-term clinical outcomes of this series of patients with anatomically complex IAOD support the current paradigm of an endovascular-first approach to revascularization.
authors.affiliation: Department of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA.
authors.forename: Philip B
authors.initials: PB
authors.lastname: Dattilo
authors.forename: Thomas T
authors.initials: TT
authors.lastname: Tsai
authors.forename: Joel A
authors.initials: JA
authors.lastname: Garcia
authors.forename: Amanda
authors.initials: A
authors.lastname: Allshouse
authors.forename: Ivan P
authors.initials: IP
authors.lastname: Casserly
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D003251:Constriction, Pathologic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency