Flexible tantalum stents for the treatment of iliac artery lesions: Long-term patency, complications, and risk factors

PURPOSE: To evaluate the long-term success of tantalum stents implanted in iliac artery lesions and to determine potential predictive factors of early and late stent failure. MATERIALS AND METHODS: In 289 patients, flexible tantalum stents were implanted in iliac artery stenoses (n = 223) or occlusions (n = 66). Early and late stent failures were evaluated at 1-79 months (mean, 23 months). Four risk factors were evaluated: lesion type (occlusion vs stenosis), lesion location (common vs external iliac artery), lesion length (<4 vs >4 cm), and quality of runoff (good vs poor). RESULTS: The frequency of early stent thrombosis was significantly (P < .001) higher in occlusions (15.2%) versus stenoses (2.7%), in external (12.8%) versus common (1.1%) iliac arteries, in long (16.7%) versus short (0.5%) lesions, and in poor (14.0%) versus good (2.1%) runoff. At multivariate analysis, runoff and location were influencing factors. Primary patency rates at 3 and 5 years were 85% and 79%, respectively, for all stents. Three-year patency rates were significantly higher in short (88%) versus long (63%) lesions and in stenoses (92%) versus occlusions (63%). At multivariate analysis,lesion length was the only predictive factor for 3-year stent patency. CONCLUSION: Stent implantation offers valuable long-term treatment for atherosclerotic iliac artery disease. Success can be predicted on the basis of risk factors.