title: Patency of the Internal Iliac Artery after Placement of Common and External Iliac Artery Stents.
abstract: BACKGROUND
  Treatment of severe aortoiliac occlusive disease (AIOD) frequently requires long-segment stenting of the common and external iliac arteries (CIA and EIA, respectively). This study aims to analyze the patency of the internal iliac artery (IIA) after placement of a CIA and EIA stents across the orifice.
  
  
  METHODS
  A retrospective analysis of all patients who underwent de novo ipsilateral stent placement in the CIA and EIA between 2006 and 2013 was performed. Kaplan-Meier analysis was used to analyze patency of the IIA, and Cox proportional hazard models were used to identify characteristics associated with occlusion.
  
  
  RESULTS
  We identified 77 patients and 93 limbs where ipsilateral CIA and EIA stents were placed. Preintervention angiographic review found 52 cases of a patent ipsilateral IIA where stents were placed across the origin of the IIA in 31 cases and staggered across the orifice in 20 limbs. Kaplan-Meier analysis demonstrated a 37% patency in limbs where the stent covered the IIA orifice compared to 78% patency in uncovered arteries (P = 0.04). New-onset buttock claudication developed in 4 patients, 2 with patent IIAs and 2 with occluded. New-onset impotence also developed in 3 patients with occluded IIA and 5 patients with patent IIAs.
  
  
  CONCLUSIONS
  Placement of stents across the origin of the IIA may not result in immediate occlusion, but long-term patency of covered IIAs is decreased compared to uncovered IIAs. This study is limited by a small sample size, but when treating AIOD, coverage of the internal iliac origin should be avoided to maintain patency of the pelvic circulation.
authors: Division of Vascular Surgery, UC Davis Medical Center, Sacramento, CA.
authors: Margie
authors: M
authors: Vinogradova
authors: Division of Vascular Surgery, UC Davis Medical Center, Sacramento, CA.
authors: Hye Joon
authors: HJ
authors: Lee
authors: Division of Cardiology, VA Denver Medical Center, Denver, CO.
authors: Ehrin J
authors: EJ
authors: Armstrong
authors: Division of Vascular Surgery, UC Davis Medical Center, Sacramento, CA.
authors: John
authors: J
authors: Laird
authors: Division of Vascular Surgery, UC Davis Medical Center, Sacramento, CA. Electronic address: dzstorm.md@gmail.com.
authors: Misty D
authors: MD
authors: Humphries
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016009:Chi-Square Distribution; D016208:Databases, Factual; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency