Skip to main content

Advertisement

SpringerLink
Log in

Primary stent placement for iliac artery chronic total occlusions

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to evaluate the technical and mid-term results of primary stent placement for chronic total occlusions (CTO) of the iliac artery, in comparison to stent placement for iliac artery stenosis.

Methods

A retrospective study was carried out on 114 consecutive limbs with 24 CTOs and 90 stenoses of the iliac artery that underwent primary stent placement. Primary, assisted primary patency, and limb salvage rates were determined in accordance with the Society for Vascular Surgery guidelines.

Results

Angiographic and intravascular ultrasonographic success was achieved in all 114 limbs (100%). Three major complications, including 1 distal embolism and 2 arterial ruptures, occurred in the CTO group. The 2-year primary patency rate in the CTO group was as high as that observed in the stenosis group (91% vs 89%). There were also no significant differences in the assisted primary patency, limb salvage, and survival rates between the two groups.

Conclusions

Our results indicate that primary stent placement is a safe and effective treatment for iliac CTOs. However, major complications, including distal embolization and iliac artery rupture, remain a significant problem, and caution should therefore be exercised when performing this technique for iliac CTOs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Motarjeme A, Keifer JW, Zuska AJ. Percutaneous transluminal angioplasty of the iliac arteries: 66 experiences. AJR 1980;135:934–944.

    Google Scholar 

  2. Ring EJ, Freiman DB, McLean GK, Schwarz W. Percutaneous recanalization of common iliac artery occlusions: unacceptable complication rate? AJR 1982;139:587–589.

    CAS  PubMed  Google Scholar 

  3. Rees CR, Palmaz JC, Garcia O, Roeren T, Richter GM, Gardiner G Jr, et al. Angioplasty and stenting of completely occluded iliac arteries. Radiology 1989;172:953–959.

    CAS  PubMed  Google Scholar 

  4. Vorwerk D, Gunther RW, Schurmann K, Wendt G, Peters I. Primary stent placement for chronic iliac artery occlusions: Follow-up in 103 patients. Radiology 1995;194:745–749.

    CAS  PubMed  Google Scholar 

  5. Dyet JF, Gaines PA, Nicholson AA, Cleveland T, Cook AM, Wilkinson AR, et al. Treatment of chronic iliac artery occlusions by means of percutaneous endovascular stent placement. J Vasc Interv Radiol 1997;8:349–353.

    Article  CAS  PubMed  Google Scholar 

  6. Reyes R, Maynar M, Lopera J, Ferral H, Gorriz E, Carreira J, et al. Treatment of chronic iliac artery occlusions with guide wire recanalization and primary stent placement. J Vasc Interv Radiol 1997;8:1049–1055.

    Article  CAS  PubMed  Google Scholar 

  7. Henry M, Amor M, Ethevenot G, Henry I, Mentre B, Tzvetanov K. Percutaneous endoluminal treatment of iliac occlusions: longterm follow-up in 105 patients. J Endovasc Surg 1998;5:228–235.

    Article  CAS  PubMed  Google Scholar 

  8. Scheinert D, Schröder M, Ludwig J, Bräunlich S, Möckel M, Flachskampf FA, et al. Stent-supported recanalization of chronic iliac artery occlusions. Am J Med 2001;110:708–715.

    Article  CAS  PubMed  Google Scholar 

  9. Uher P, Nyman U, Lindh M, Lindblad B, Ivancev K. Long-term results of stenting for chronic iliac artery occlusion. J Endovasc Ther 2002;9:67–75.

    Article  PubMed  Google Scholar 

  10. Funovics MA, Lackner B, Cejna M, Peloschek P, Sailer J, Philipp MO, et al. Predictors of long-term results after treatment of iliac artery obliteration by transluminal angioplasty and stent deployment. Cardiovasc Intervent Radiol 2002;25:397–402.

    Article  CAS  PubMed  Google Scholar 

  11. Carnevale FC, De Blas M, Merino S, Egana JM, Caldas JGMP. Percutaneous endovascular treatment of chronic iliac artery occlusion. Cardiovasc Interv Radiol 2004;27:447–452.

    Article  CAS  Google Scholar 

  12. Gandini R, Fabiano S, Chiocchi M, Chippa R, Simonetti G. Percutaneous treatment in iliac artery occlusion: long-term results. Cardiovasc Interv Radiol. 2008;31:1069–1076.

    Article  Google Scholar 

  13. Greiner A, Dessl A, Klein-Weigel P, Neuhauser B, Perkmann R, Waldenberger P, et al. Kissing stents for treatment of complex aortoiliac disease. Eur J Vasc Endovasc Surg 2003;26:161–165.

    Article  CAS  PubMed  Google Scholar 

  14. Haulon S, Mounier-Véhier C, Gaxotte V, Koussa M, Lions C, Haouari BA, et al. Percutaneous reconstruction of the aortoiliac bifurcation with the “kissing stents” technique: long-term follow-up in 106 patients. J Endovasc Ther 2002;9:363–368.

    Article  PubMed  Google Scholar 

  15. Mouanoutoua M, Maddikunta R, Allaqaband S, Gupta A, Shalev Y, Tumuluri R, et al. Endovascular intervention of aortoiliac occlusive disease in high risk patients using the kissing stents technique: long-term results. Catheter Cardiovasc Interv 2003;60:320–326.

    Article  PubMed  Google Scholar 

  16. Nishibe T, Kondo Y, Muto A, Nishibe M, Dardik A. Stent placement of femoropopliteal arterial occlusive disease in high-risk patients: preliminary results. Surg Today 2009;39:21–26.

    Article  PubMed  Google Scholar 

  17. Cikrit DF, Gustafson PA, Dalsing MC, Harris VJ, Lalka SG, Sawchuk AP, et al. Long-term follow-up of the Palmaz stent for iliac occlusive disease. Surgery 1995;118:608–613.

    Article  CAS  PubMed  Google Scholar 

  18. Henry M, Amor M, Ethevenot G, Henry I, Amicabile C, Beron R, et al. Palmaz stent placement in iliac and femoropopliteal arteries: primary and secondary patency in 310 patients with 2–4-year follow-up. Radiology 1995;197:167–174.

    CAS  PubMed  Google Scholar 

  19. Vorwerk D, Günther RW, Schürmann K, Wendt G. Aortic and iliac stenoses: follow-up results of stent placement after insufficient balloon angioplasty in 118 cases. Radiology 1996;198:45–48.

    CAS  PubMed  Google Scholar 

  20. Palmaz JC, Laborde JC, Rivera FJ, Encarnacion CE, Lutz JD, Moss JG. Stenting of the iliac arteries with the Palmaz stent: experience from a multicenter trial. Cardiovasc Interv Radiol 1992;15:291–297.

    Article  CAS  Google Scholar 

  21. Murphy KD, Encarnacion CE, Le VA, Palmaz JC. Iliac artery stent placement with the Palmaz stent: follow-up study. J Vasc Interv Radiol 1995;6:321–329.

    Article  CAS  PubMed  Google Scholar 

  22. Laborde JC, Palmaz JC, Rivera FJ, Encarnacion CE, Picot MC, Dougherty SP. Influence of anatomic distribution of atherosclerosis on the outcome of revascularization with iliac stent placement. J Vasc Interv Radiol 1995;6:513–521.

    Article  CAS  PubMed  Google Scholar 

  23. Klein WM, van der Graaf Y, Seeger J, Spithoven JH, Buskens E, van Baal JG, et al. Dutch iliac stent trial: long-term results in patients randomized for primary and selective stent placement. Radiology 2006;238:734–744.

    Article  PubMed  Google Scholar 

  24. Jacobs DL, Motaganahalli RL, Cox DE, Wittgen CM, Peterson GJ. True lumen re-entry devices facilitate subintimal angioplasty and stenting of total chronic occlusions: Initial report. J Vasc Surg 2006;43:1291–1296.

    Article  PubMed  Google Scholar 

  25. de Vries SO, Hunink MG. Results of aortic bifurcation grafts for aortoiliac occlusive disease: meta-analysis. J Vasc Surg 1997;26:558–569.

    Article  PubMed  Google Scholar 

  26. Criado E, Burnham SJ, Tinsley EA Jr, Johnson G Jr, Keagy BA. Femorofemoral bypass graft: analysis of patency and factors influencing long-term outcome. J Vasc Surg 1993;18:495–504.

    Article  CAS  PubMed  Google Scholar 

  27. Schneider JR, McDaniel MD, Walsh DB, Zwolak RM, Cronenwett JL. Axillofemoral bypass: outcome and hemodynamic results in high-risk patients. J Vasc Surg 1992;15:952–962.

    Article  CAS  PubMed  Google Scholar 

  28. Chatziioannou A, Mourikis D, Katsimilis J, Skiadas V, Koutoulidis V, Katsenis K, et al. Acute iliac artery rupture: endovascular treatment. Cardiovasc Interv Radiol 2007;30:281–285.

    Article  CAS  Google Scholar 

  29. Ishii H, Kumada Y, Toriyama T, Aoyama T, Takahashi H, Yamada S, et al. Cilostazol improves long-term patency after percutaneous transluminal angioplasty in hemodialysis patients with peripheral artery disease. Clin J Am Soc Nephrol 2008;3:1034–1040.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Eniwa Midorino Clinic, 1-5-2 Midorimachi, Eniwa, Hokkaido, 061-1402, Japan

    Yuka Kondo, Masayasu Nishibe & Toshiya Nishibe

  2. Department of Vascular Surgery, Yale University School of Medicine, New Haven, CT, USA

    Yuka Kondo, Alan Dardik & Akihito Muto

  3. Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan

    Jun Koizumi

Authors
  1. Yuka Kondo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alan Dardik
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Akihito Muto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jun Koizumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Masayasu Nishibe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Toshiya Nishibe
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kondo, Y., Dardik, A., Muto, A. et al. Primary stent placement for iliac artery chronic total occlusions. Surg Today 40, 433–439 (2010). https://doi.org/10.1007/s00595-009-4102-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-009-4102-x

Key words

Search

Navigation