Portal de Periódicos da CAPES

Immediate Stenting of Iliofemoral Occlusive Lesions: A Surgeon's Early Experiences

1999; SAGE Publishing; Volume: 6; Issue: 3 Linguagem: Inglês

10.1583/1074-6218(1999)006 2.0.co;2

2168-1961

Stephen W.K. Cheng, Albert C.W. Ting, Hung Lau, John Wong,

Aortic aneurysm repair treatments

To report the early and midterm results of balloon angioplasty and immediate stenting of atherosclerotic iliofemoral lesions in an operating room setting.Sixty-one patients (41 men, mean age 70 +/- 8 years, range 49 to 86) underwent balloon dilation and systematic stenting for 80 stenotic and occlusive lesions in the iliac (n = 47) and superficial femoral (n = 33) arteries in 72 limbs. One hundred two stents (63 VascuCoil, 33 Wallstent, and 6 miscellaneous) were placed. Patients were followed with serial duplex scans at 3-month intervals.Initial technical success by intention-to-treat was 96.2% (77/80) (iliac: 100%, femoral: 90.9% [30/33]). There were 9 (11.3%) procedure-related complications and no deaths. Initial success by anatomic, hemodynamic, and clinical limb criteria were 100%, 95%, and 94.4%, respectively. Thirty procedures were performed for limb salvage with a success rate of 86.7%. Six patients (7 limbs) died during follow-up of unrelated causes. Fifty-nine (81.9%) limbs were available for duplex follow-up over a mean 17.7 months (range 3 to 37). Cumulative patency rates were 87.3% at 2 years for iliac stents and 66.6% at 18 months for femoral stents with an overall 2-year patency rate of 76.3%. The only independent risk factors affecting late patency were the site of angioplasty, stent diameter, lesion grade, and the preoperative ankle-brachial index. Stents placed with a diameter < or = 5 mm and > 5 mm had 1-year patency rates of 51.0% and 97.6%, respectively (p = 0.004)Iliac and femoral angioplasty and immediate stenting have acceptable midterm patency rates. The patency of femoral stenting is inferior and is adversely affected by stents < or = 5 mm in diameter.