Title:
Unilateral Iliac Artery Stenting Improves Perfusion and Symptoms in Both
Limbs in Patients With Bilateral Iliac Lesions
Languages of Item:
English
Abstract:
Purpose: To test the hypothesis that unilateral dilation of a common
(CIA) or internal iliac artery (IIA) stenosis in selected patients with
contralateral chronic iliac artery occlusion is adequate to offer
clinical benefit to the untreated chronically occluded limb.
Methods: Sixteen patients (11 men; mean age 66.7 +/- 4.9 years) with
chronic occlusion of one CIA [with or without extension to the
external iliac artery (EA)] and CIA stenosis (n=11), IIA stenosis (n=3),
CIA and IIA stenoses (n=1), or IIA and EIA stenoses (n=1) on the
contralateral side were treated with unilateral angioplasty/stenting of
the iliac artery stenosis as sole treatment for both limbs. Clinical and
hemodynamic success of this approach was assessed for both limbs.
Results: Eleven patients were treated with stenting of the stenosed CIA,
2 with IIA dilation, one with IIA stenting, one with stenting of both
the CIA and IIA, and the last with IIA and EIA stenting. Technical
success was obtained in all. Immediate hemodynamic success was also
100% for both limbs: the mean resting ankle-brachial index increased
from 0.67 +/- 0.06 to 0.88 +/- 0.04 on the stenosis side and from to
0.53 +/- 0.06 to 0.69 +/- 0.07 in the contralateral occluded limb
(p<0.001). Clinical success was 100% for the treated limb immediately
after the procedure and 93.8% for the contralateral limb. One patient
with ischemic rest pain in the occluded limb continued to experience
severe symptoms after contralateral CIA stenting despite hemodynamic
improvement; he had a femorofemoral graft implanted 2 months after the
initial intervention and was considered the only clinical failure.
During a mean 24-month follow-up (range 12-54), all stented arteries
remained patent.
Conclusion: In selected patients with CIA or IIA stenosis and long
chronic occlusion of the contralateral iliac axis, unilateral
dilation/stenting of the stenosis alone increases blood flow and
improves clinical symptoms to both limbs. J Endovasc Ther.
2013;20:106-112
Authors:
Klonaris, Chris
Katsargyris, Athanasios
Papapetrou, Anastasios
and Chatziioannou, Achilleas
Georgopoulos, Sotirios
Journal:
Journal of Endovascular Therapy
Publisher:
SAGE Publications Inc.
Keywords:
iliac occlusive disease; stenosis; occlusion; common iliac artery;
internal iliac artery; stent; angioplasty; collaterals; chronic total
occlusion
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