Long-term results after recanalisation of chronic iliac artery occlusions by combined catheter therapy without stent placement

Objectives: to evaluate the long-term outcome after recanalisation of chronic iliac artery occlusions by combined catheter therapy without stent placement. Design: retrospective study. Material and methods: between 1979 and 1995 75 consecutive patients were treated (53 men, 22 women; mean age 63.1 +/- 13.7 years; mean length of the occluded segment 6.9 +/- 3.5 cm). The indication for treatment was incapacitating claudication (n = 55) or chronic critical ischaemia (n = 20). At follow-up clinical data, pulse volume and pressure measurements were recorded and duplex-sonography and/or angiography performed, if clinically indicated. Results: mean follow-up was 7.2 +/- 4.1 years. The primary clinical success rate was 64% at 12 months, 57% at 4 years and remained stable for up to ten years. The secondary clinical success rate after 12 months was 83% and remained stable at 81% for up to 10 years. Peripheral embolisation as complication of the intervention occurred in 18 patients (24%) and was treated by percutaneous thromboembolectomy in 15 patients during the same procedure. In the remaining three patients no intervention was necessary. One patient had to undergo surgery for a groin haematoma. Conclusions: recanalisation of segmental chronic iliac artery occlusions by catheter therapy without stent placement has favourable long-term results comparable to primary stent placement. Randomised controlled studies are required to determine the appropriate role of catheter therapy alone and primary or selective stenting for iliac artery occlusions.