Initial experience with the palmaz stent for aortoiliac stenoses

Abstract

The initial 37 consecutive patients to be treated at our institution with the Palmaz stent placed in the aortoiliac arteries were retrospectively reviewed. In these patients, 50 stenoses and six occlusions were treated with 128 stents. Nine patients with combined iliac and common femoral obstruction underwent common femoral endarterectomy and profundaplasty with intraoperative iliac artery angioplasty and stent application. Stenoses were reduced from 57±17% to 1±5% (p<0.01), and peak systolic pressure gradients across the lesions were reduced from 45±30 mm Hg to 1.3±3.4 mm Hg (p<0.01). Symptoms resolved in 27 patients and improved in eight patients. One patient died and four patients were treated nonoperatively for complications. During a mean follow-up of 12 months (6 to 21 months), six patients had recurrence of symptoms (16%) and four patients died of other diseases. Routine arteriograms after 6 months in 19 patients demonstrated recurrent mild to moderate stenoses (9% to 43%) in six patients (32%), but only two were symptomatic (11%). Secondary procedures included reexpansion of aortic and iliac stents in two patients and aortofemoral bypass in two patients. Early results suggest the efficacy of the Palmaz stent in the management of aortoiliac stenoses and its use intraoperatively in conjunction with surgical correction of outflow. Close follow-up of these patients by multidisciplinary groups is warranted.