Short- and midterm results of iliac artery stenting for flush occlusion with the assistance of an occlusive contralateral iliac artery balloon.

Abstract

BACKGROUND:

Endovascular treatment of flush iliac artery occlusion remains a challenge and is most often performed using open surgery. We report the outcomes of 10 cases that were successfully recanalized endovascularly with the assistance of a contralateral occlusive balloon.

METHODS:

A retrospective review of patients undergoing iliac artery stenting was performed at a single institution. Technical success, short- and midterm patency, and 30-day complications are reported.

RESULTS:

Ten patients were identified. Technical success was 100% when a brachial approach was used. Retrograde recanalization was attempted in 3 cases. Reentry into the aorta could not be achieved in 1 case. The aorta was entered above the inferior mesenteric artery (IMA) in the other 2 cases, and the decision was made to attempt a brachial approach to avoid stenting above the IMA. There were no dissections or perforations. Two patients developed brachial access complications, but only 1 required operative repair for a pseudoaneurysm. Nine patients (90%) remained patent at a mean follow-up of 14.6 months (range 9-24 months). One patient presented 9 months later with iliac artery stent and lower extremity bypass thromboses, which resulted in an amputation. There were no deaths in this series.

CONCLUSIONS:

Iliac stenting for flush iliac artery occlusion can be achieved with this technique with encouraging short- and midterm results and minimal morbidity.

• Authors: Carlos F Bechara, Neal R Barshes, George Pisimisis, Jeffrey T Bates, Peter H Lin, Panagiotis Kougias
• Journal: Annals of vascular surgery (Ann Vasc Surg) Vol. 28 Issue 1 Pg. 59-64 (Jan 2014) ISSN: 1615-5947 [Electronic] Netherlands
• PMID: 24189002 (Publication Type: Journal Article)
• Copyright: Published by Elsevier Inc.

Topics

• Angioplasty, Balloon (adverse effects, instrumentation)
• Arterial Occlusive Diseases (diagnosis, physiopathology, therapy)
• Female
• Humans
• Iliac Artery (diagnostic imaging, physiopathology)
• Male
• Middle Aged
• Prosthesis Design
• Radiography
• Retrospective Studies
• Stents
• Time Factors
• Treatment Outcome
• Vascular Access Devices
• Vascular Patency