Randomized clinical trial of stents versus angioplasty for the treatment of iliac artery occlusions (STAG trial)

Abstract

ISRCTN 48145465 (http://www.controlled-trials.com).

SCAI expert consensus statement for aorto‐iliac arterial intervention appropriate use

“…The stent data for more complex lesions such as TASC C/D and other CTO lesions are also encouraging (Table II) [14,18,19,22,24]. According to two recent meta-analyses [18,19], immediate technical success rates for aorto-iliac intervention exceed 90%, with 4-5 year primary patency rates of 60-86%, secondary patency rates of 80-98%, and limb salvage rates of 98%.…”

“…Several studies have compared the outcomes of percutaneous transluminal angioplasty (PTA) with provisional stenting to primary stenting for both iliac stenosis and occlusions [20][21][22] The Dutch iliac stent trial found that PTA with provisional stenting (for a residual gradient of >10 mmHg) had similar results to primary stenting [9] However, this study excluded patients with more complex lesions (lesions >10 cm or CTO's >5 cm). By employing a provisional stenting strategy in the iliac artery, stent placement was avoided in 63% of the lesions.…”

“…According to two recent meta-analyses [18,19], immediate technical success rates for aorto-iliac intervention exceed 90%, with 4-5 year primary patency rates of 60-86%, secondary patency rates of 80-98%, and limb salvage rates of 98%. The STAG trial compared primary stenting with percutaneous transluminal angioplasty for iliac occlusion and showed stents improved technical success and major procedural complication rates, but no statistical difference was noted between groups at 1 or 2 years in primary or secondary patency [22].…”

“…Anatomic location of the stent is a factor in patency. Patency rates have been shown to be higher in the CIA than in the EIA [22]. The long-term (10-year) results of aortic bifurcation arterial self-expanding stent placement show a 10-year primary stent patency rate of 68% with a secondary assisted patency rate of 86% [27].…”

Current Trends and outcomes: Endovascular Management in Arteriosclerosis Obliterans (ASO) of Lower Limb Vessels

“…complexity of disease, the differing segments of iliac artery to be treated, and the use of either balloon-expandable or self-expanding nitinol stents. [90,91] Currently there are no randomized data available regarding comparing outcomes of aortoiliac stenting with these 2 types of stents. Self-expanding stents are good to avoid arterial rupture.…”