Document Detail


Aortoiliac insufficiency: long-term experience with stent placement for treatment.
MedLine Citation:
PMID:  15068949     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To establish and report the authors' experience with the long-term outcomes of aortoiliac stent placement for treatment of chronic lower-extremity ischemia. MATERIALS AND METHODS: Stents were placed in 505 arterial segment lesions in 365 patients who presented with symptoms of chronic leg ischemia between February 1992 and March 2001. The 505 treated lesions were 88 occlusions and 417 stenoses. Indications for stent placement were claudication in 312 (62%), rest pain in 107 (21%), ulcer in 67 (13%), and gangrene in 19 (4%) arterial segments. Patients were followed up for up to 105 months (mean, 33 months +/- 27 [SD]). RESULTS: Hemodynamic success was achieved in 484 (98%) of the 496 limbs for which postprocedural translesion pressure gradients were available. Mean ankle-brachial indexes improved from 0.53 +/- 0.25 to 0.79 +/- 0.23 (P <.001). Major complications were seen in 24 (7%) patients. Two patients (0.5%) died within 30 days after stent placement. Twenty (6%) of 355 patients underwent aortic or iliac bypass surgery during the follow-up period. Eight years after stent placement, primary patency was 74%; primary assisted patency, 81%; and secondary patency, 84%. Variables associated with better patency included stenosis (rather than occlusion), shorter lesion length, older age, and limb-threatening ischemia. At the last follow-up examination, 74% of the 466 limbs for which follow-up clinical status data were available were asymptomatic, 22% were associated with claudication, 3% were associated with rest pain, and 1% were associated with ischemic tissue loss. Five patients underwent amputation on the ipsilateral side after stent placement. CONCLUSION: Findings from long-term experience with aortoiliac stent placement for treatment of chronic lower-extremity ischemia confirmed the procedure to be a durable, low-risk revascularization option.
Authors:
Timothy P Murphy; Nikki S Ariaratnam; Wilfred I Carney; Edward J Marcaccio; Jeffrey M Slaiby; Gregory M Soares; H Myra Kim
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2004-02-19
Journal Detail:
Title:  Radiology     Volume:  231     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-04-07     Completed Date:  2004-05-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  243-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright RSNA, 2004
Affiliation:
Division of Vascular and Interventional Radiology, Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aorta / pathology,  physiopathology,  surgery
Aortic Diseases / surgery*
Arterial Occlusive Diseases / surgery*
Blood Vessel Prosthesis Implantation
Female
Follow-Up Studies
Humans
Iliac Artery / pathology,  physiopathology,  surgery
Intermittent Claudication / surgery
Ischemia / surgery
Lower Extremity / blood supply*
Male
Middle Aged
Postoperative Complications / etiology,  mortality,  physiopathology
Retrospective Studies
Stents*
Survival Analysis
Time
Treatment Outcome
Vascular Patency / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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