Endovascular Treatment of External Iliac Artery Occlusive Disease: Midterm Results

• Published in: Journal of endovascular therapy Vol. 21; no. 2; pp. 223 - 229
• Main Authors: Suero, Sergio Revuelta, López, Isaac Martínez, Rydings, Manuel Hernando, de Marino, Pablo Marqués, Jerez, Ana Saiz, Mateo, Manuela Maria Hernández, Hernando, Francisco Javier Serrano
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-04-2014; Allen Press Inc
• Subjects: Adult; Aged; Aged, 80 and over; Angioplasty, Balloon - adverse effects; Constriction, Pathologic; Critical Illness; Female; Humans; Iliac Artery - physiopathology; Intermittent Claudication - diagnosis; Intermittent Claudication - physiopathology; Intermittent Claudication - therapy; Ischemia - diagnosis; Ischemia - physiopathology; Ischemia - therapy; Male; Middle Aged; Morbidity; Mortality; Patients; Peripheral Arterial Disease - diagnosis; Peripheral Arterial Disease - physiopathology; Peripheral Arterial Disease - therapy; Prosthesis Design; Retrospective Studies; Stents; Studies; Success; Surgery; Survival analysis; Time Factors; Treatment Outcome; Vascular Patency; Veins & arteries; stent; patency; endovascular repair; critical limb ischemia; external iliac artery; chronic total occlusion; covered stent; balloon angioplasty; claudication; stenosis
• ISSN: 1526-6028; 1545-1550
• DOI: 10.1583/13-4443MR.1

Purpose
To report midterm outcomes for endovascular treatment of external iliac
artery (EIA) occlusive disease and assess possible factors affecting
patency.
Methods
A retrospective analysis was conducted of 99 consecutive patients (91 men;
mean age 67.3 years) with claudication (n=70) or critical limb
ischemia (n=29) owing to occlusive EIA disease treated at our center
from January 2005 to June 2012. The majority of lesions (79/108) were TASC
A/B. Lesions were a mean 42.2 mm long (range 10–125); 43/108 affected
the distal third of the EIA. Balloon angioplasty alone was performed in 7
limbs, while the remaining 101 lesions were stented (65 self-expanding, 24
balloon-expandable, and 12 covered). Clinical and hemodynamic follow-up was
performed at 1, 3, 6, and 12 months after therapy and yearly thereafter. The
factors examined were procedure characteristics and patency rates.
Results
Over a median follow-up of 27.5 months (range 1–89), there were 2
(1.9%) early occlusions followed by a successful reintervention, 4
late occlusions, and 5 hemodynamic failures followed by 7 reinterventions.
These events led to primary and secondary patency rates at 30 months of
89.7% and 94.1%, respectively. No differences in patency rates
were detected according to age, clinical state, or comorbidity. Use of
covered stents (p=0.006) was the only variable associated with lower
primary patency rates.
Conclusion
Endovascular therapy to treat TASC A/B lesions of the EIA yielded good short
and midterm patency and low early morbidity and mortality. Lesions involving
the distal third of the EIA treated by simple angioplasty ± stenting
fared worse. No clinical factors could be correlated with patency.