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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):161-9
language: English, Italian
Angioplasty and stenting in iliac axis occlusions
Biasi G., Gasparini D. *, Sponza M. *, Gonano N., Marzio A. **, Santarelli R., Fregonese V., Andolfato G., Pfeiffer P., Mozzon L.
From the Vascular Surgery Unit * Radio-diagnostic Unit ** Institute of Radiology, University of Udine «Santa Maria della Misericordia» Hospital - Udine
Background. This study aimed to evaluate the long-term patency of iliac axes after angioplasty and stenting treatment of complete occlusions.
Methods. Fifty complete iliac occlusions were treated in 40 patients (mean age 67 years suffering from peripheral vascular disease of the lower limbs in class II B and class III LF over the period January 1996-December 1998. In 1 case, the treatment followed acute ischemia of the leg in long-term class II A peripheral vascular disease.
Results. Arteriography scan before surgery revealed 16 occlusions of the common iliac artery, 22 of the external iliac artery and 12 of the overall iliac axis. All cases were treated with angioplasty, immediately followed by the implant of stents (wallstent or thermal stent). The follow-up included 32 out of 40 patients for 30-72 months using clinical or ultrasound tests, and angiography in some cases. As for the remaining 8 patients, 3 died for reasons not related to treatment and 5 could not be traced. Primary patency was confirmed in 29 out of 32 patients. The angiography of 1 patient showed a re-occlusion of the iliac axis 36 months after treatment. Two more patients presented occlusions after 12-46 months and were treated with angioplasty and brachytherapy. Secondary patency is still being monitored.
Conclusions. Percutaneous angioplasty combined with stenting is a valid alternative to aortic-femoral bypass in complete occlusions of the iliac axis.