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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Giornale Italiano di Chirurgia Vascolare 2002 June;9(2):149-59
language: English, Italian
Direct iliac stenting. Mid- and long-term results
Zennaro M., Zanchetta M., Pedon L., Rigatelli G., Faresin F., Ronsivalle S., Maiolino P.
From the Department of Cardiovascular Diseases Hospital of Cittadella, Cittadella (Padova)
Background. To evaluate the feasibility of stenting without predilatation and to define the long-term outcome of direct stent placement in iliac arteries.
Methods. From May 1966 to September 2000, we performed 154 direct stent placements in 116 patients according to the procedure suggested by Richter and described by Dorros and Mathiak. One hundred and fifty-four stents were directly implanted into iliac arteries: 121 balloon-expandable Palmaz stents, 31 self-expandable stents (15 Wallstent, 12 Symphony, 2 Sinus and 2 Memotherm) 1 Intrastent, 1 Passager, 1 Perflex and 1 AVE. Long-term patency rates were determined by duplex ultrasonography and angiography.
Results. Immediate procedural and clinical success was achieved in all patients. Angiographies performed in patients revealed restenosis rates of 0.5%. Survival analysis revealed 4-year primary patency rates of 96.7%. Most restenotic lesions were successfully treated with repeat angioplasty. Neither cardiovascular risk nor other independent variables were statistically significant to predict procedural success. In accordance with the literature, no differences were found either in the procedural success rates between common iliac arteries (n=89) and external iliac arteries (n=65), or between stenosis (n=142) and occlusions (n=12).
Conclusions. We regard direct stent implantation in iliac arteries as a safe and efficient procedure. It allows long-term patency and is more favorable than PTA alone. It is probably superior to direct anatomic reconstruction both in the treatment of stenosis and occlusions. We also think that when primary stenting is planned, many iliac atherosclerotic lesions can be treated with considerable cost effectiveness.