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Efficacy of stent-supported subintimal angioplasty in the treatment of long iliac artery occlusions

 Young-Guk Ko  ;  Sanghoon Shin  ;  Kwang Joon Kim  ;  Jung-Sun Kim  ;  Myeong-Ki Hong  ;  Yangsoo Jang  ;  Won-Heum Shim  ;  Donghoon Choi 
 JOURNAL OF VASCULAR SURGERY, Vol.54(1) : 116-122, 2011 
Journal Title
Issue Date
Aged ; Angioplasty/instrumentation* ; Angioplasty/methods ; Angioplasty, Balloon/instrumentation* ; Arterial Occlusive Diseases/diagnostic imaging ; Arterial Occlusive Diseases/physiopathology ; Arterial Occlusive Diseases/therapy* ; Chi-Square Distribution ; Chronic Disease ; Constriction, Pathologic ; Female ; Humans ; Iliac Artery*/diagnostic imaging ; Iliac Artery*/physiopathology ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Proportional Hazards Models ; Registries ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stents* ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome ; Vascular Patency
BACKGROUND: Subintimal angioplasty (SA) is becoming increasingly accepted as a revascularization technique for chronic arterial occlusive disease. However, its efficacy in iliac artery occlusions has not been established. Therefore, we investigated the procedural and clinical outcomes of subintimal angioplasty in long iliac artery occlusions and compared them with those of intraluminal angioplasty (IA) in nonocclusive stenotic iliac artery lesions.

METHODS: We retrospectively analyzed data from 151 consecutive patients with long (>5 cm) iliac artery lesions (204 limbs) who underwent angioplasty with primary stent implantation from October 2004 through July 2008. Among them, 100 lesions in 100 patients were treated with intentional SA, and 104 lesions in 82 patients were treated with IA. We compared the baseline characteristics and immediate and long-term outcomes of iliac artery lesions treated with SA versus IA.

RESULTS: Baseline characteristics showed that longer lesions and critical limb ischemia were found more frequently in the SA group, whereas diabetes and combined femoropopliteal lesions were present more often in the IA group. The technical success rate of SA was lower than that of IA (93.0% vs 99.0%; P = .048). However, there was no significant difference in the procedure-related complications between the SA and IA groups (4.0% vs 4.8%; P = .779). Primary patency rates for SA and IA were 96.8% and 98.0% at 1 year, and 93.9% and 90.6% at 2 years, respectively (log rank P = .656).

CONCLUSION: Stent-supported SA in occlusive iliac lesions was safe and showed a high long-term patency rate comparable to that of IA performed in nonocclusive iliac lesions despite longer lesion length. Thus, SA with implantation of stents is an effective technique for the treatment of chronic long iliac artery occlusion.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Shin, Sang Hoon(신상훈)
Shim, Won Heum(심원흠)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
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