Clinical outcomes with contemporary endovascular therapy of iliac artery occlusive disease

Catheter Cardiovasc Interv. 2012 Oct 1;80(4):644-54. doi: 10.1002/ccd.23469. Epub 2012 Mar 14.

Abstract

Objectives: We sought to evaluate the clinical outcomes of a consecutive series of patients treated for iliac artery occlusive disease (IAOD) using contemporary endovascular technology and techniques.

Background: As an increasingly complex spectrum of IAOD is treated using endovascular revascularization, there is a need to examine the rates of acute procedural success, complications, and patency to validate the role of an endovascular-first approach to revascularization in contemporary practice.

Methods: All patients with IAOD who were treated using endovascular therapy between September 2005 and September 2010 were identified from a prospectively collected database. Baseline patient characteristics, anatomic details, procedural data, and clinical outcomes were assessed retrospectively. Patency and mortality rates were estimated with the Kaplan-Meier method.

Results: A total 59 patients underwent 62 procedures. Trans-Atlantic Inter-Society Consensus (TASC) II types B, C, and D disease accounted for 59%, 7%, and 37% of patients, respectively. The procedure was technically successful in 60 of 62 cases (97%) with no procedure-related mortality. Major complications occurred in five procedures (8%). The mean (±standard deviation) duration of follow-up was 2.3 ± 1.4 years. In patients with a successful revascularization, primary and secondary patency rates were 86% and 94% at 1 year, and 77% and 91% at 2 years, respectively. The TASC II classification of disease did not predict the rate of acute technical success or medium-term patency rates.

Conclusions: The acute and medium-term clinical outcomes of this series of patients with anatomically complex IAOD support the current paradigm of an endovascular-first approach to revascularization.

MeSH terms

  • Aged
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / mortality
  • Arterial Occlusive Diseases / physiopathology
  • Arterial Occlusive Diseases / therapy*
  • Constriction, Pathologic
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / instrumentation
  • Endovascular Procedures* / mortality
  • Female
  • Humans
  • Iliac Artery* / diagnostic imaging
  • Iliac Artery* / physiopathology
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Radiography
  • Retrospective Studies
  • Stents
  • Time Factors
  • Treatment Outcome
  • Vascular Patency