Totally occluded iliac arteries: long-term results of percutaneous transluminal angioplasty.

PURPOSE: To evaluate the initial and long-term results of percutaneous transluminal angioplasty (PTA) for totally occluded iliac arteries.

METHODS

Fifty-four occluded iliac arteries in 54 patients were treated by PTA. The mean length of the occlusions was 8.0 cm (range 0.5-24.0 cm). Patients were followed for a maximum of 124 months (mean, 56 months).

RESULTS

The initial success rate was 57% (31 of 54). On follow-up study, two arteries were reoccluded, and six showed evidence of restenosis. These recurrences were observed within 20 months after PTA. The long-term results obtained by Kaplan-Meier life-table analysis revealed a 71% primary patency rate and 93% secondary patency rate for 124 months. Thirteen arteries were treated by surgical intervention, while the other arteries with unsuccessful PTA were followed conservatively because of a high risk for surgery or patients' refusal to have surgery. Major complications were recorded in 7% (4 of 54) of cases: thrombosis requiring emergent bypass surgery in one artery, and distal embolization requiring thromboembolectomy in three.

CONCLUSION

Although the procedure is difficult, the long-term results suggest that PTA is an effective method and a treatment of choice for totally occluded iliac arteries.