Endovascular Treatment of Iliac Artery Chronic Total Occlusions

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Abstract

Approximately 8.5 million American adults are affected by peripheral artery disease (PAD). The iliac arteries and infrarenal aorta are among the arterial circulations most commonly affected by atherosclerotic chronic total occlusion (CTO) and constitute approximately one third of cases of PAD. Percutaneous angioplasty for iliac CTO was first described by Tegtmeyer et al. in 1979 in a 55-year-old diabetic woman with nonhealing foot ulcers in association with a CTO of the right common iliac artery (CIA) [1]. While surgical bypass can be performed with high long-term patency for aortoiliac PAD, endovascular interventions are increasingly being used to treat disabling claudication in such patients [2]. Surgical bypass options vary based on the specific anatomy, but include aortofemoral or aorta bi-femoral bypass, iliofemoral bypass, femoral-femoral bypass, and aortoiliac endarterectomy. Surgical bypass is associated with satisfactory improvement in symptoms and long-term patency rates, but such operations may incur significant operative morbidity and mortality. Thus endovascular aortoiliac interventions are often considered as a first-line treatment strategy for symptomatic patients with aortoiliac disease [2, 3].

Keywords

Iliac Artery Peripheral Artery Disease Internal Iliac Artery Common Iliac Artery Chronic Total Occlusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References

  1. 1.
    Tegtmeyer CJ, Moore TS, Chandler JG, Wellons HA, Rudolf LE. Percutaneous transluminal dilatation of a complete block in the right iliac artery. AJR Am J Roentgenol. 1979;133:532–5.CrossRefPubMedGoogle Scholar
  2. 2.
    Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WRC, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM, White CJ, White J, White RA, Antman EM, Smith SC, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B, American Association for Vascular Surgery, Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, ACC/AHA Task Force on Practice Guidelines Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease, American Association of Cardiovascular and Pulmonary Rehabilitation, National Heart Lung and Blood Institute, Society for Vascular Nursing, TransAtlantic Inter-Society Consensus, Vascular Disease Foundation. ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. J Am Coll Cardiol. 2006;113:e463–654.Google Scholar
  3. 3.
    Klein AJ, Feldman DN, Aronow HD, Gray BH, Gupta K, Gigliotti OS, Jaff MR, Bersin RM, White CJ, Peripheral Vascular Disease Committee for the Society for Cardiovascular Angiography and Interventions. SCAI expert consensus statement for aorto-iliac arterial intervention appropriate use. Cathet Cardiovasc Interv. 2014;84:520–8.Google Scholar
  4. 4.
    Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FGR, TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45:S5–67.CrossRefPubMedGoogle Scholar
  5. 5.
    Dattilo PB, Tsai TT, Garcia JA, Allshouse A, Casserly IP. Clinical outcomes with contemporary endovascular therapy of iliac artery occlusive disease. Catheter Cardiovasc Interv. 2012;80:644–54.CrossRefPubMedGoogle Scholar
  6. 6.
    Bosch JL, Hunink MG. Meta-analysis of the results of percutaneous transluminal angioplasty and stent placement for aortoiliac occlusive disease. Radiology. 1997;204:87–96.CrossRefPubMedGoogle Scholar
  7. 7.
    Scheinert D, Schröder M, Ludwig J, Bräunlich S, Möckel M, Flachskampf FA, Balzer JO, Biamino G. Stent-supported recanalization of chronic iliac artery occlusions. Am J Med. 2001;110:708–15.CrossRefPubMedGoogle Scholar
  8. 8.
    Carnevale FC, De Blas M, Merino S, Egaña JM, Caldas JGMP. Percutaneous endovascular treatment of chronic iliac artery occlusion. Cardiovasc Intervent Radiol. 2004;27:447–52.CrossRefPubMedGoogle Scholar
  9. 9.
    Leville CD, Kashyap VS, Clair DG, Bena JF, Lyden SP, Greenberg RK, O'Hara PJ, Sarac TP, Ouriel K. Endovascular management of iliac artery occlusions: extending treatment to TransAtlantic Inter-Society Consensus class C and D patients. J Vasc Surg. 2006;43:32–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Ozkan U, Oguzkurt L, Tercan F. Technique, complication, and long-term outcome for endovascular treatment of iliac artery occlusion. Cardiovasc Intervent Radiol. 2010;33:18–24.CrossRefPubMedGoogle Scholar
  11. 11.
    Papakostas JC, Chatzigakis PK, Peroulis M, Avgos S, Kouvelos G, Lazaris A, Matsagkas MI. Endovascular treatment of chronic total occlusions of the iliac arteries. Early and mid-term results. Ann Vasc Surg. 2015;29:1508–15.CrossRefPubMedGoogle Scholar
  12. 12.
    Millon A, Schiava Della N, Brizzi V, Arsicot M, Boudjelit T, Herail J, Feugier P, Lermusiaux P. The antegrade approach using transbrachial access improves technical success rate of endovascular recanalization of TASC C-D aortoiliac occlusion in case of failed femoral access. Ann Vasc Surg. 2015;29:1346–52.CrossRefPubMedGoogle Scholar
  13. 13.
    Cortese B, Trani C, Lorenzoni R, Sbarzaglia P, Latib A, Tommasino A, Bovenzi F, Cremonesi A, Burzotta F, Pitì A, Tarantino F, Colombo A. Safety and feasibility of iliac endovascular interventions with a radial approach. Results from a multicenter study coordinated by the Italian Radial Force. Int J Cardiol. 2014;175:280–4.CrossRefPubMedGoogle Scholar
  14. 14.
    Rogers RK, Tsai T, Casserly IP. Novel application of the “CART” technique for endovascular treatment of external iliac artery occlusions. Catheter Cardiovasc Interv. 2010;75:673–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Mwipatayi BP, Thomas S, Wong J, Temple SEL, Vijayan V, Jackson M, Burrows SA, Covered Versus Balloon Expandable Stent Trial (COBEST) Co-investigators. A comparison of covered vs bare expandable stents for the treatment of aortoiliac occlusive disease. J Vasc Surg. 2011;54:1561–70.CrossRefPubMedGoogle Scholar
  16. 16.
    Mendelsohn FO, Santos RM, Crowley JJ, Lederman RJ, Cobb FR, Phillips HR, Weissman NJ, Stack RS. Kissing stents in the aortic bifurcation. Am Heart J. 1998;136:600–5.CrossRefPubMedGoogle Scholar
  17. 17.
    Scheinert D, Schröder M, Balzer JO, Steinkamp H, Biamino G. Stent-supported reconstruction of the aortoiliac bifurcation with the kissing balloon technique. Circulation. 1999;100:II295–300.CrossRefPubMedGoogle Scholar
  18. 18.
    Yilmaz S, Sindel T, Golbasi I, Turkay C, Mete A, Lüleci E. Aortoiliac kissing stents: long-term results and analysis of risk factors affecting patency. J Endovasc Ther. 2006;13:291–301.CrossRefPubMedGoogle Scholar
  19. 19.
    Mohamed F, Sarkar B, Timmons G, Mudawi A, Ashour H, Uberoi R. Outcome of “kissing stents” for aortoiliac atherosclerotic disease, including the effect on the non-diseased contralateral iliac limb. Cardiovasc Intervent Radiol. 2002;25:1–1.CrossRefGoogle Scholar
  20. 20.
    Björses K, Ivancev K, Riva L, Manjer J, Uher P, Resch T. Kissingstents in the aortic bifurcation – a valid reconstruction for aorto-iliac occlusive disease. Eur J Vasc Endovasc Surg. 2008;36:424–31.CrossRefPubMedGoogle Scholar
  21. 21.
    Haulon S, Mounier-Véhier C, Gaxotte V, Koussa M, Lions C, Haouari BA, Beregi JP. Percutaneous reconstruction of the aortoiliac bifurcation with the “kissing stents” technique: long-term follow-up in 106 patients. J Endovasc Ther. 2002;9:363–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Sabri SS, Choudhri A, Orgera G, Arslan B, Turba UC, Harthun NL, Hagspiel KD, Matsumoto AH, Angle JF. Outcomes of covered kissing stent placement compared with bare metal stent placement in the treatment of atherosclerotic occlusive disease at the aortic bifurcation. JVIR. 2010;21:995–1003.CrossRefPubMedGoogle Scholar
  23. 23.
    Krishnamurthy VN, Eliason JL, Henke PK, Rectenwald JE. Intravascular ultrasound-guided true lumen reentry device for recanalization of unilateral chronic total occlusion of iliac arteries: technique and follow-up. Ann Vasc Surg. 2010;24:487–97.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Singapore 2017

Authors and Affiliations

  1. 1.Division of CardiologyUniversity of ColoradoAuroraUSA
  2. 2.Denver VA Medical CenterDenverUSA

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