Iliac artery stent placement with the Palmaz stent: follow-up study

Purpose The long-term efficacy of iliac artery stent placement with the Palmaz stent was evaluated for treatment of limb ischemia. Patients and Methods Iliac stent implantation for limb ischemia was performed on 108 limbs in 83 patients. Eighty patients (96.4%) were followed up clinically from 1 to 70 months (mean, 25.8 months), and 30 patients (37.5%) were followed up with angiography from 1 to 48 months (mean, 10.4 months). Patients were classified into six categories by using an ischemic ranking profile. Clinical success was defined as a minimum one-category improvement from preprocedure ranking. Results The clinical success rate was 98.9% immediately after the procedure and 86.2% at 48 months. Long-term success was statistically more common in patients with higher preprocedure and lower postprocedure ischemic ranking, and in patients without diabetes. Arteriography demonstrated a primary patency rate of 87.5% at latest follow-up, with five occlusions (12.5%) and only two (5.0%) restenoses. Average stenosis was 17.8% at 6 months and 24.7% at 2 years. Stent restenosis was statistically more common with a higher post-procedure pressure gradient. The complication rate was 9.7%, and 30-day mortality was 1.2%. Conclusion Long-term clinical and angiographic follow-up demonstrates iliac artery stent placement with the Palmaz stent is safe and efficacious for treatment of limb ischemia.