Mid-term outcomes following endovascular re-intervention for iliac artery in-stent restenosis

Usman Javed, Christopher R. Balwanz, Ehrin J. Armstrong, Khung Keong Yeo, Gagan D. Singh, Satinder Singh, David Anderson, Gregory G. Westin, William C. Pevec, John R. Laird

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Objectives We sought to evaluate the procedural characteristics and clinical outcomes of endovascular repair for iliac artery (IA) in-stent restenosis (ISR). Background An increasing percentage of patients with complex IA occlusive disease are treated with an endovascular approach, but the outcomes of IA-ISR have not been well described. Methods We analyzed all endovascular procedures for treatment of IA-ISR performed at our institution between July 2006-December 2010. The primary outcome was primary patency, defined as <50% stenosis as assessed by clinical examination and duplex ultrasonography (DUS). Results Forty-one lesions in 24 patients who underwent repeated endovascular intervention for treatment of IA-ISR. Most lesions were unilateral and involved the common IA (66%). The mean length of ISR was 30.1 ± 14.1 mm with type I (focal) and II (diffuse) ISR occurring with the greatest frequency (34% and 39%, respectively). All patients underwent balloon angioplasty; adjunctive stenting zwas performed in 27 (66%) of the lesions. Type II ISR lesions more frequently required stenting (13/16 lesions, P = 0.02 compared with other patterns of ISR). Procedural success was 100% with a mean gain of 0.13 in the ankle-brachial index (P = 0.001). The 6- and 12-month primary patency rates were 96% and 82%, respectively. The 12-month primary-assisted patency rate was 90% with clinically driven target lesion revascularization (TLR) in three patients. Conclusions Endovascular treatment of IA-ISR using an approach of balloon angioplasty followed by selective stenting is associated with high-patency rates and low rates of TLR at 1 year.

Original languageEnglish (US)
Pages (from-to)1176-1184
Number of pages9
JournalCatheterization and Cardiovascular Interventions
Volume82
Issue number7
DOIs
StatePublished - Dec 1 2013

Keywords

  • iliac artery
  • in-stent restenosis
  • peripheral arterial disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Javed, U., Balwanz, C. R., Armstrong, E. J., Yeo, K. K., Singh, G. D., Singh, S., Anderson, D., Westin, G. G., Pevec, W. C., & Laird, J. R. (2013). Mid-term outcomes following endovascular re-intervention for iliac artery in-stent restenosis. Catheterization and Cardiovascular Interventions, 82(7), 1176-1184. https://doi.org/10.1002/ccd.24975