A J Leu1, E Schneider, C R Canova, U Hoffmann. 1. Department of Internal Medicine, Division of Angiology, University Hospital, R]amistrasse 100, Z]urich, CH-8091, Switzerland.
Abstract
OBJECTIVES: to evaluate the long-term outcome after recanalisation of chronic iliac artery occlusions by combined catheter therapy without stent placement. DESIGN: retrospective study. MATERIAL AND METHODS: between 1979 and 1995 75 consecutive patients were treated (53 men, 22 women; mean age 63.1+/-13.7 years; mean length of the occluded segment 6.9+/-3.5 cm). The indication for treatment was incapacitating claudication (n=55) or chronic critical ischaemia (n=20). At follow-up clinical data, pulse volume and pressure measurements were recorded and duplex-sonography and/or angiography performed, if clinically indicated. RESULTS: mean follow-up was 7. 2+/-4.1 years. The primary clinical success rate was 64% at 12 months, 57% at 4 years and remained stable for up to ten years. The secondary clinical success rate after 12 months was 83% and remained stable at 81% for up to 10 years. Peripheral embolisation as complication of the intervention occurred in 18 patients (24%) and was treated by percutaneous thromboembolectomy in 15 patients during the same procedure. In the remaining three patients no intervention was necessary. One patient had to undergo surgery for a groin haematoma. CONCLUSIONS: recanalisation of segmental chronic iliac artery occlusions by catheter therapy without stent placement has favourable long-term results comparable to primary stent placement. Randomised controlled studies are required to determine the appropriate role of catheter therapy alone and primary or selective stenting for iliac artery occlusions. Copyright 1999 Harcourt Publishers Ltd.
OBJECTIVES: to evaluate the long-term outcome after recanalisation of chronic iliac artery occlusions by combined catheter therapy without stent placement. DESIGN: retrospective study. MATERIAL AND METHODS: between 1979 and 1995 75 consecutive patients were treated (53 men, 22 women; mean age 63.1+/-13.7 years; mean length of the occluded segment 6.9+/-3.5 cm). The indication for treatment was incapacitating claudication (n=55) or chronic critical ischaemia (n=20). At follow-up clinical data, pulse volume and pressure measurements were recorded and duplex-sonography and/or angiography performed, if clinically indicated. RESULTS: mean follow-up was 7. 2+/-4.1 years. The primary clinical success rate was 64% at 12 months, 57% at 4 years and remained stable for up to ten years. The secondary clinical success rate after 12 months was 83% and remained stable at 81% for up to 10 years. Peripheral embolisation as complication of the intervention occurred in 18 patients (24%) and was treated by percutaneous thromboembolectomy in 15 patients during the same procedure. In the remaining three patients no intervention was necessary. One patient had to undergo surgery for a groin haematoma. CONCLUSIONS: recanalisation of segmental chronic iliac artery occlusions by catheter therapy without stent placement has favourable long-term results comparable to primary stent placement. Randomised controlled studies are required to determine the appropriate role of catheter therapy alone and primary or selective stenting for iliac artery occlusions. Copyright 1999 Harcourt Publishers Ltd.