Covered stents for symptomatic iliac artery in-stent restenosis treatment: Midterm Results

Konstantinos Palialexis, Stavros Spiliopoulos, Apostolos Dalakidis, Elias Primetis, Dimitrios Mourikis, Achilles Chatziioannou


Purpose: To evaluate the safety and efficacy of balloon-expandable covered stent (CS) for treatment of symptomatic iliac artery in-stent restenosis (ISR).

Material and methods: This was a retrospective, single-arm, single-centre study, which included 25 consecutive patients referred for percutaneous endovascular treatment of angiographically proven symptomatic iliac artery ISR using balloon expandable CS. All patients presented with recurrent Rutherford 1 to 3 chronic limb ischaemia that deteriorated over an average period of 45 months after bare stenting. Study’s primary safety outcome measures were peri-procedural (30-days) device-related major complications rate and 12 months patient survival rate, while primary efficacy outcome measure was 12-months clinically-driven target lesion reintervention rate. Secondary endpoints included 12-months binary restenosis rates and 30-day procedure related complication rates.

Results: Initial technical success was 100%. No device-related major complications occurred. No patient was lost to follow up. According to Kaplan-Meier analysis target lesion revascularisation-free survival rates were 92% at 6- and 12-months follow up, respectively. Restenosis rates were 8% and 12% at 6- and 12-months follow up, respectively. Survival was 100% (25/25 patients). No major complications were noted (0%). Minor complication rate was 4% (1/25 case of medium size haematoma).

Conclusions: The use of a balloon-expandable covered stent seems to achieve promising results in the management of symptomatic iliac artery in-stent restenosis.

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