Annals of Vascular Surgery

, Volume 9, Issue 5, pp 453–458 | Cite as

Stenting without thrombolysis for aortoiliac occlusive disease: Experience in 14 high-risk patients

  • Jeffrey L. Ballard
  • Frank C. Taylor
  • Steven R. Sparks
  • J. David Killeen
Papers Presented at the Southern California Vascular Surgical Society
  • 3 Downloads

Abstract

Stenting without thrombolysis of 16 occluded iliac artery segments and one occluded infrarenal abdominal aorta was attempted in 14 patients. All patients were either considered to be prohibitive operative risks or had contraindications to thrombolytic therapy. Indications for limb reperfusion included rest pain, disabling claudication, or dry gangrene. Successful recanalization was achieved primarily in 13 patients with self-expandable Wallstents, balloon-expandable Palmaz stents, or a combination of the two stents. Follow-up was carried out in all patients in whom recanalization was successful. All stented patients showed symptomatic improvement, and the mean preprocedure ankle/brachial index, which was 0.31, improved to 0.78 after the procedure (p = 0).Complications included a vertebrobasilar stroke during the procedure in one patient, perforation during angioplasty of a stenotic but nonoccluded external iliac artery in one, and dissection of the distal external iliac artery in one. Distal embolization did not occur. Percutaneous recanalization of aortoiliac occlusions without initial thrombolysis is possible and has a high potential for technical success. Additional data and longer follow-up are still needed, but this procedure may provide a reasonable, less invasive option in some patients at high surgical risk or in patients who have contraindications to thrombolytic therapy.

Keywords

Thrombolytic Therapy External Iliac Artery Distal Embolization High Surgical Risk Invasive Option 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Palmaz JC. Intravascular stents: Tissue-stent interactions and design considerations. Am J Roentgenol 1993;160:613–618.Google Scholar
  2. 2.
    Vorwerk D, Gunther RW. Stent placement in iliac arterial lesions: Three years of clinical experience with the Wallstent. Cardiovasc Intervent Radiol 1992;15:285–290.PubMedGoogle Scholar
  3. 3.
    Long AL, Gaux JC, Raynaud AC, et al. Infrarenal aortic stents: Initial clinical experience and angiographic follow-up. Cardio-vasc Intervent Radiol 1993;16:203–208.Google Scholar
  4. 4.
    Blum U, Gabelmann A, Redecker M, et al. Percutaneous recanalization of iliac artery occlusions: Results of a prospective study. Radiology 1993;189:536–540.PubMedGoogle Scholar
  5. 5.
    Long AL, Page PE, Raynaud AC, et al. Percutaneous iliac artery stent: Angiographic long-term follow-up. Radiology 1991;180: 771–778.PubMedGoogle Scholar
  6. 6.
    Reyes R. Self-expandable stents in the treatment of complete iliac occlusion: Midterm follow-up. Abstract presented at the Society of Cardiovascular and Interventional Radiology 1994 Annual Scientific Session, San Diego, Calif.Google Scholar
  7. 7.
    Murphy KD. Iliac artery stent placement with the Palmaz stent: Follow-up study. Abstract presented at the Society of Cardiovascular and Interventional Radiology 1994 Annual Scientific Session, San Diego, Calif.Google Scholar
  8. 8.
    Thomas MR, Wainwright RJ. Use of an intracoronary stent to control intrapericardial bleeding during coronary artery rupture complicating coronary angioplasty. Cathet Cardiovasc Diagn 1993;30:169–172.PubMedGoogle Scholar
  9. 9.
    Kim D, Orron DE. Techniques and complications of angiography. In Kim D, Orron DE, eds. Peripheral Vascular Imaging and Intervention. St. Louis: Mosby-Year Book, 1992, pp 83–109.Google Scholar

Copyright information

© Annals of Vascular Surgery Inc. 1995

Authors and Affiliations

  • Jeffrey L. Ballard
    • 1
  • Frank C. Taylor
    • 2
  • Steven R. Sparks
    • 1
  • J. David Killeen
    • 1
  1. 1.Division of Vascular SurgeryLoma Linda University Medical CenterLoma Linda
  2. 2.Divisions of Interventional RadiologyLoma Linda University Medical CenterLoma Linda

Personalised recommendations