Influence of Anatomic Distribution of Atherosclerosis on the Outcome of Revascularization with Iliac Stent Placement

Jean Claude Laborde, Julio C. Palmaz, Frank J. Rivera, Carlos E. Encarnacion, Marie Christine Picot, Sarsfield P. Dougherty

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

Purpose: To determine the influence of clinical and angiographic variables, including the anatomic disease pattern, on the outcome of iliac stent placement. Patients and Methods: The 455 patients of the study population were divided in three groups according to the anatomic distribution of their peripheral atherosclerosis lesions. Pattern type 1 (focal aortoiliac and/or common iliac lesion) included 180 patients (39.6%), type 2 (external iliac lesion) comprised 58 patients (12.8%), and type 3 (multilevel lesions) included 217 patients (47.7%). Results: Complete relief of symptoms immediately after revascularization was observed in 88.3% and 85.4% of patients with pattern type 1 and 2, respectively, compared to 60.1% with type 3 (P < .05). The persistence of clinical benefit at 36-month follow-up was 91.6%, 97.9%, and 60.8% in disease patterns 1, 2, and 3, respectively. The overall 1-year mortality rate was 3% with type 1 lesions, 5.7% with type 2, and 9.7% with type 3. On multivariate logistic regression, the presence of a disease pattern type 3 was the most powerful indicator (P < .001) of early unsatisfactory clinical outcome in iliac stent placement. Unexpectedly, female gender was predictive of unsatisfactory clinical outcome (P < .01) and higher periprocedural complications (P < .001) following iliac stent revascularization. Conclusions: Pattern type classification helps identify patients at higher risk for cardiovascular morbidity and mortality. Ideal candidates for iliac stent placement are patients with pattern type 1 or 2 disease.

Original languageEnglish (US)
Pages (from-to)513-521
Number of pages9
JournalJournal of Vascular and Interventional Radiology
Volume6
Issue number4
DOIs
StatePublished - Jul 1995

Keywords

  • Arteries, grafts and prostheses, 98.1268
  • Arteries, iliac, 98.1268, 98.721
  • Arteriosclerosis, 98.721
  • Stents and prostheses, 98.1268

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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