Iliac and femoral artery stenoses and occlusions: treatment with intravascular stents.

Abstract

Forty-five patients with atherosclerotic stenoses and occlusions of the iliac and superficial femoral arteries were treated with a flexible, self-expanding, metallic intravascular stent. Of these patients, 37 were treated immediately after inadequate angioplasty. At a follow-up period of 2-12 months, intravenous digital subtraction angiograms demonstrated patency of the vessels with stents in 40 of 45 patients. The mean Doppler ankle/arm index increased from 0.60 to 0.92 immediately after treatment and was 0.89 at follow-up. Early thrombotic stent occlusion occurred in two patients. Intimal hyperplasia was a late effect and led to stent stenoses in three patients after 5-9 months and stent occlusion in one patient after 6 months. In three patients, percutaneous recanalization with balloon and Simpson catheters was successful. Intravascular stents proved particularly useful for maintenance of patency after angioplasty in occlusions of the iliac and femoral arteries and in treatment of stenoses due to eccentric and severely ulcerated plaques. The stents also helped manage complications after angioplasty. Long-term results will depend on the degree, frequency, and progression of intimal hyperplasia narrowing the vascular lumen.