Interventional therapy of iliac artery lesions with a new premounted balloon-expandable stent.

Purpose: Evaluation of the handling, technical success rate and six month patency rate of a new, premounted balloon-expandable stent in iliac artery lesions. Materials and methods: In a prospective study 26 stenoses and 3 occlusions of the iliac arteries were primary treated in 24 patients (Fontaine IIa-III, mean age 60.4 year) with the "Flexible Iliac Bridge Stent" (Medtronic AVE, Dusseldorf). Five patients had bilateral stenoses. The ankle-brachial index (ABI) ire rest and after exercise was determined before the intervention as well as 1-3 days, 1 and 6 months after the intervention. The handling and visibility of the stent was scored on a three grade scale by the operators. Follow-up angiography including intraarterial pressure measurement was performed in 17 out of 24 patients (21 out of 29 lesions) after 6 months. Results: All 29 lesions were treated with technical success by implantation of 36 stents. The mean degree of the stenoses before intervention was 72.7+/-13.8% (+/-1 standard deviation) and less than 5% in all cases postinterventionally. The mean pressure gradient before and after stent placement was 21+/-13.1 mm Hg and 0.8+/-2.3 mm Hg, respectively. The Fontaine stage improved by at least one in all patients. The mean ABI at rest improved from 0.63+/-0.15 to 0.89+/-0.16, and after exercise from 0.46+/-0.17 to 0.8+/-0.2, respectively. At 6 months 2 lesions out of 21 (9.5%) showed a restenosis of 55% and 70% with an intraarterial pressure gradient of 16 mm Hg and 27 mm Hg, respectively. After 6 months the mean ABI at rest decreased to 0.83+/-0.13, and to 0.72+/-0.14 after exercise. Handling and visibility was scored as good by all operators. Conclusion: Endoluminal therapy of iliac artery lesions with the used stent is safe and effective. The six month patency rate is comparable to the published data of other stents.