Two-year outcome of the self-expandable stent for chronic total occlusion of the iliac artery
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ORIGINAL ARTICLE
Two-year outcome of the self-expandable stent for chronic total occlusion of the iliac artery Motoharu Araki • Keisuke Hirano • Masatsugu Nakano • Yoshiaki Ito • Hiroshi Ishimori • Masahiro Yamawaki • Shinya Sasaki • Hideyuki Takimura • Yasunari Sakamoto • Takuro Takama • Reiko Tsukahara • Toshiya Muramatsu
Received: 3 April 2013 / Accepted: 11 September 2013 Ó Japanese Association of Cardiovascular Intervention and Therapeutics 2013
Abstract To evaluate the 2-year results obtained with self-expandable stent for chronic total occlusion (CTO) of the iliac artery, a retrospective study was performed of patients who underwent endovascular therapy (EVT) for chronic iliac artery CTO who presented from April 2007 to September 2012. 82 patients with 86 occluded iliac arteries underwent successful recanalization and stenting with a self-expandable stent. The primary equivalence end point was a composite of restenosis, mortality, target vessel revascularization, and limb salvage rates. Patients were followed up with the presence of a palpable femoral artery pulse, resolution of symptoms, and noninvasive vascular laboratory testing reviewed at 1, 3, and 6 months after EVT and then were evaluated at 6-month intervals. In patients who gave consent, repeat angiography was done in sixtyone of 86 lesions (70.1 %) for follow-up. The mean followup was at 27.6 ± 17.8 months (range 3–60 months). All stents were placed in the true lumen under intravascular ultrasound (IVUS) guidance. There were no cases of peripheral embolization or iliac artery rupture after the procedure. The ankle-brachial index increased significantly from 0.55 ± 0.19 to 0.88 ± 0.17 (P \ 0.001). The primary patency rate was 96.5 % at 2 years. The MLD immediately after the procedure was 5.10 ± 0.26 mm and increased significantly to 5.40 ± 0.28 mm at the period of follow-up angiography. The 2-year outcome of endovascular therapy
M. Araki (&) K. Hirano M. Nakano Y. Ito H. Ishimori M. Yamawaki S. Sasaki H. Takimura Y. Sakamoto T. Takama R. Tsukahara T. Muramatsu Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, 3-6-1 Shimosueyoshi Tsurumiku, Yokohama City, Kanagawa 260-0012, Japan e-mail: [email protected]
with self-expandable stents for CTO of the iliac artery had an acceptable result. Keywords Iliac artery Intravascular ultrasound Self-expandable stent
The Transatlantic Inter-Society Consensus II (TASC II) was revised in 2007, with endovascular therapy for the iliac artery being established as a minimally invasive treatment option [1]. Stenting of chronic iliac occlusion is a safe and durable alternative to surgical treatment, especially in comparison with aortobifemoral bypass, and is also considered to be the primary modality for TASC A, B, and C lesions [2]. Several authors have reported suboptimal results when treating chronic total occlusion (CTO) of the iliac artery with stents because of difficulty in crossing heavily calcified lesions, as well as a higher incidence of major complic
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