Bare Stents for Iliac Chronic Total Occlusions (“TELIS”): A Prospective Cohort Study with a Midterm Follow-up

Abstract

This study aims to assess primary bare stenting for iliac chronic total occlusions (CTOs) with midterm follow-up. From April 2013 to May 2016, all patients presenting with symptomatic iliac CTO were treated endovascularly and included in a prospective single-center cohort. Common iliac CTOs were treated with balloon-expandable bare-metal stents. External iliac lesions were treated with bare self-expandable nitinol stents. Primary end point was primary sustained clinical improvement. A total of 49 iliac CTOs were treated in 46 patients. A total of 22 lesions were located at the level of the common iliac artery (45%), 20 at the external iliac artery (41%), and 7 extending to both (14%). Mean stenting length was 114.4±49.8mm. Technical success was 98%. Primary sustained clinical improvement was achieved for 93.4±3.7% of patients at 12months and 87.7±5.2% at 24months. Three in-stent thrombosis were observed with no restenosis in the remaining patients at 24months. Freedom from target lesion revascularization was 93.3%±3.7% at 24months. Three stent fractures were noted, none were symptomatic. Mean quality of life (EQ5D-3L) was significantly improved at 24months (71.2±20.3 vs. 52.4±22.6, P=0.001). Our results showed that primary bare-metal stenting for iliac CTO is safe and efficient at 24months and could be considered as a first-line strategy.