Comparing patency rates between external iliac and common iliac artery stents.

Abstract

Placement of intraluminal stents in the common iliac artery (CIA) and external iliac artery (EIA) has become an accepted therapy for treating localized arterial stenoses. The purpose of this study was to compare anatomic patency rates of stents placed in the EIA and CIA for occlusive disease. A radiologic computer database was used to identify 69 consecutive male patients at the Minneapolis Veterans Affairs Medical Center from February 1, 1993, through January 31, 1999, who underwent placement of 98 stents (82 Wallstents and 16 Palmaz stents) for physiologically significant iliac artery occlusive disease and varying degrees of chronic limb ischemia. Patients were followed up with surveillance duplex ultrasound scanning examinations 1 day after procedure, 3 months after procedure, and then at 6-month intervals after stent placement. Follow-up angiograms were performed for patients with duplex ultrasound scans that revealed velocities greater than 300 cm/s. Patient risk factors, iliac artery runoff, concomitant outflow procedures, and anatomic patency rates were compared between patients receiving EIA stents and those receiving CIA stents. The mean age for the EIA stent group was 69 +/- 1 years versus 66 +/- 1 years (P =.03) for the CIA stent group. Mean follow-up was 21.4 +/- 2.1 months (+/- SE) for all patients. Patients with EIA stents had more ischemic lower limbs when compared with patients who had CIA stents (P =.05). No differences were found between groups in risk factor analysis (P = not significant). Lesion lengths were similar between groups: EIA, 4.6 +/- 0.6 cm, and CIA, 5. 3 +/- 0.8 cm (P = not significant). The following differences were noted on primary patency rates (EIA group vs CIA group): 1 year (93% vs 88%), 2 years (91% vs 85%), and 3 years (90% vs 78%) (Cox proportional hazards; P =.13). Anatomic patency rates for EIA and CIA stents appear to be similar despite the fact that patients with EIA stents were older and had more ischemic limbs compared with the patients who had CIA stents.