Document Detail


Long-term cardiovascular morbidity, mortality, and reintervention after endovascular treatment in patients with iliac artery disease: The Dutch Iliac Stent Trial Study.
MedLine Citation:
PMID:  15286319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare long-term cardiovascular morbidity and mortality and their determinants in a population initially treated with one of two endovascular treatment strategies for stenosis or short occlusion of an iliac artery. MATERIALS AND METHODS: A total of 279 symptomatic patients with stenosis or short (< or =5-cm) occlusion of the iliac arteries were randomly assigned to undergo either primary stent placement or primary angioplasty followed by selective stent placement (in case of a residual mean pressure gradient greater than 10 mm Hg at the treated site). Follow-up data for all 279 patients were provided by the general practitioners and referring clinicians. Events of interest were arterial interventions, reinterventions in the iliac arteries, cardiovascular events (myocardial infarction, stroke, or extracranial bleeding), and death. Regression analysis was performed to identify predictors of reintervention and of cardiovascular morbidity and mortality. RESULTS: The mean follow-up period was 5.6 years +/- 1.3 (+/- standard deviation). There were no significant differences between primary stent placement and primary angioplasty treatment groups in regard to number of reinterventions in the treated iliac arteries (33 [18%] of 187 segments and 33 [20%] of 169 segments, respectively) or in the ipsilateral legs (45 [25%] of 181 legs and 50 [30%] of 164 legs, respectively). The risk of other cardiovascular events in primary stent placement and primary angioplasty groups was 13% (18 of 143) and 11% (15 of 136), and the risk of death was 15% (21 of 143 patients) and 16% (22 of 136 patients), respectively. Sex, presence of critical ischemia, and length of stenosis were predictors of whether a patient would require iliac reintervention. Myocardial infarction, stroke, and vascular death were predicted on the basis of a patient's creatinine level and walking distance as tested at the time of inclusion. CONCLUSION: No difference was found in the number of reinterventions between the two treatment groups 5 years after treatment. Patients with iliac artery disease are at high risk of cardiovascular morbidity and mortality.
Authors:
Willemijn M Klein; Yolanda van der Graaf; Jan Seegers; Frans L Moll; Willem P T M Mali
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Radiology     Volume:  232     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-08-02     Completed Date:  2004-09-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  491-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright RSNA, 2004
Affiliation:
Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E.01.132, 3584 CX Utrecht, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon / instrumentation*
Arterial Occlusive Diseases / mortality,  therapy*
Arteriosclerosis / mortality,  therapy
Cause of Death
Combined Modality Therapy
Creatinine / blood
Death, Sudden, Cardiac / epidemiology
Exercise Test
Female
Follow-Up Studies
Hemorrhage / mortality*
Humans
Iliac Artery*
Ischemia / mortality,  therapy
Leg / blood supply
Male
Middle Aged
Myocardial Infarction / mortality*
Netherlands
Retreatment / mortality
Risk
Stents*
Stroke / mortality*
Chemical
Reg. No./Substance:
60-27-5/Creatinine

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


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