Long-term Results 10 Years after Iliac Arterial Stent Placement

Schürmann, K.; Mahnken, Andreas H.; Meyer, J; Haage, Patrick; Chalabi, Khaled; Peters, Ilse; Günther, Rolf W.; Vorwerk, Dierk

doi:10.1148/radiol.2242011101

Cited by 73 publications

(51 citation statements)

References 16 publications

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“…The lesions occur typically at the aortic bifurcation, with disease extending into the origin of each common iliac artery. Stenoses are more common than occlusions by a 4:1 ratio [14].…”

Section: Discussionmentioning

confidence: 99%

“…Stenting is less feasible for infra-inguinal arterial lesions, because the long-term results of stenting are not better than those of PTA in spite of its good short-term results [14]. In a recent study that measured long-term outcomes of aortoiliac stent placement in treatment of 365 patients with chronic lower-extremity ischemia, primary patency was 74%, primary assisted patency 81%, and secondary patency 84%, eight years after stent placement [15].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Multidetector CT Evaluation in Arterial Stenting

Indrajit¹,

Souza²,

Bedi

et al. 2006

Medical Journal Armed Forces India

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“…The lesions occur typically at the aortic bifurcation, with disease extending into the origin of each common iliac artery. Stenoses are more common than occlusions by a 4:1 ratio [14].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multidetector CT Evaluation in Arterial Stenting

Indrajit¹,

Souza²,

Bedi

et al. 2006

Medical Journal Armed Forces India

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“…Late results remain good, with long-term cumulative patency rates of up to 66% at 5 years [12]. In this respect, the best management of diffusely diseased and occluded iliac arteries is in flux.…”

Section: Percutaneous Treatment Strategiesmentioning

confidence: 98%

“…In this respect, the best management of diffusely diseased and occluded iliac arteries is in flux. • Iliac artery stenting has restenosis rates as low as 0.5%, as well as primary patency rates of 86% at 4 years [13], 66% at 5 years, and 46% at 10 years after the procedure [12]. The rationale behind stent use is to improve longterm outcomes compared with PTA alone, and to prevent abrupt vessel closure following complex interventions.…”

Section: Percutaneous Treatment Strategiesmentioning

confidence: 99%

Lower extremity arterial occlusive disease: Role of percutaneous revascularization

Kanani

Garasic

2005

Curr Treat Options Cardio Med

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Percutaneous endovascular interventions for peripheral arterial disease are indicated in carefully selected patients with favorable anatomy and associated clinical symptoms. Although endovascular therapy appears to be hemodynamically equivalent to other modalities in isolated iliac disease, this does not appear to be the case for infrainguinal disease, particularly when the disease is diffuse and extensive. Such disease in these beds can often be treated surgically, although there is an increasing role for percutaneous therapies, particularly in patients at higher surgical risk. Catheter-based therapy should be considered an integral part of comprehensive medical therapy in patients with lower extremity peripheral arterial disease. Embarking on an endovascular approach to therapy should involve a frank physician-patient discussion of the risks, benefits, and durability of the proposed procedure tailored to anatomic locale and patient-specific factors.

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“…Restenosis is the main drawback of endovascular treatment of the iliac and femoral arteries [1][2][3][4]. Conflicting experimental and clinical results have been reported for patency rates and restenosis in the iliofemoral arteries with different stent designs [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Oversizing and Restenosis with Self-Expanding Stents in Iliofemoral Arteries

Saguner

Traupe

Räber

et al. 2011

Cardiovasc Intervent Radiol

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Purpose Uncoated self-expanding nitinol stents (NS) are commonly oversized in peripheral arteries. In current practice, 1-mm oversizing is recommended. Yet, oversizing of NS may be associated with increased restenosis. To provide further evidence, NS were implanted in porcine iliofemoral arteries with a stent-to-artery-ratio between 1.0 and 2.3. Besides conventional uncoated NS, a novel selfexpanding NS with an antiproliferative titanium-nitrideoxide (TiNOX) coating was tested for safety and efficacy. Methods Ten uncoated NS and six TiNOX-coated NS (5-6 mm) were implanted randomly in the iliofemoral artery of six mini-pigs. After implantation, quantitative angiography (QA) was performed for calculation of artery and minimal luminal diameter. Follow-up was performed by QA and histomorphometry after 5 months. Results Stent migration, stent fracture, or thrombus formation were not observed. All stents were patent at followup. Based on the location of the stent (iliac/femoral) and the stent-to-artery-ratio, stent segments were divided into ''normal-sized'' (stent-to-artery-ratio \ 1.4, n = 12) and ''oversized'' (stent-to-artery-ratio C 1.4, n = 9). All stent segments expanded to their near nominal diameter during follow-up. Normal-sized stent segments increased their diameter by 6% and oversized segments by 29%. A significant correlation between oversizing and restenosis by both angiography and histomorphometry was observed. Restenosis rates were similar for uncoated NS and TiNOXcoated NS. Conclusions TiNOX-coated NS are as safe and effective as uncoated NS in the porcine iliofemoral artery. All stents further expand to near their nominal diameter during follow-up. Oversizing is linearly and positively correlated with neointimal proliferation and restenosis, which may not be reduced by TiNOX-coating.

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Long-term Results 10 Years after Iliac Arterial Stent Placement

Abstract: The main cause of death in patients with intermittent claudication was cardiac disease. Long-term patency of iliac arterial stents was moderate.

Cited by 73 publications

References 16 publications

Multidetector CT Evaluation in Arterial Stenting

Multidetector CT Evaluation in Arterial Stenting

Lower extremity arterial occlusive disease: Role of percutaneous revascularization

Oversizing and Restenosis with Self-Expanding Stents in Iliofemoral Arteries

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