Balloon-expandable, intraluminal stenting of the iliac arteries with the Palmaz stent was the subject of a multicenter study for 4 years. A total of 486 patients underwent 587 procedures. Four hundred and five patients had unilateral and 81 had bilateral iliac stent placements. Follow-up ranged from 1 to 48 months (mean 13.3 +/- 11 months). Sustained clinical benefit of the treated patients was obtained in 90.9% at 1 year, 84.1% at 2 years, and 68.6% at 43 months. Angiographic patency rate was 92%. Diabetes mellitus and poor runoff had significant negative influence on the clinical outcome. The 10% incidence of procedural complications was not altered by operator experience.

Retrospective analysis of 36 embolization procedures in 29 patients with gastrointestinal bleeding was undertaken, and the presence or absence of coagulopathy was identified as a major factor affecting embolization outcome. Embolization was successful in 18 of 29 (62%) patients and unsuccessful in 11 (38%). Eight of 11 failures (73%) occurred in patients with a coagulopathy, whereas three patients (27%) in whom embolization was successful also had a coagulopathy. Embolization was 2.9 times more likely to be unsuccessful (P = .0463) and death from bleeding after embolization was 9.6 times more likely to occur (P = .0065) in patients with a coagulopathy than in those without. Because embolization was successful in six of 14 (43%) coagulopathy patients, the authors advocate embolization in patients with gastrointestinal bleeding and coagulopathy, while all efforts to correct the coagulopathy would be made as early as possible.

No abstract

Endovascular treatment of aortoiliac aneurysms with stent-graft devices may be an alternative to surgery.

No abstract