Stenting of Extensive Occlusive Disease of the Iliac Segment inPatients with High CardiovascularRisk

The purpose of our study was to evaluate immediate and long-term results of endovascular treatment in patients with a high risk of cardiovascular events and radiographic or angiographic evidence of extensive occlusive disease of iliac segment (TASC C, D). Methods: We have included in this prospective, non-randomized study 166 patients with the diagnosis of atherosclerotic aortoiliac occlusive disease. All patients had a high risk of cardiovascular events and an objective evidence of TASC C, D iliac occlusive disease. One hundred and six iliac endovascular procedures were performed. Results: Early (< 30 days) stent thrombosis was detected in 4 cases (2.4%). In 4 (2.4%) patients, there was an evidence of post-procedural distal thromboembolism. The mean follow-up was 38.8 months.   At the end of the 48-month follow-up period, thrombosis of the stented iliac segment was detected in 16 (9.6%) patients. In 14 (8.4%) patients, above-the-knee amputation was required. The cumulative primary stent patency at 1, 2, 3 and 4 years was 94,3 ± 2.3%; 86.3 ± 3,6%; 75,2 ± 5,3% and 68,9 ± 7,3% respectively. The limb salvage rate in our study at 1, 2 and 3 years was 96.2 ± 2,1%, 90 ± 3.3 and 86,3 ± 4.8%, respectively. Conclusions: Iliac artery stenting is an effective minimally invasive treatment for high surgical rick patients with extensive occlusive iliac disease (TASC II type C and D), at least in the mid-term.