Endovascular Treatment of Iliac Artery Total Occlusions: A Single Center Experience

Objective: The purpose of the study is to present our experience and treatment efficacy in patients with total occlusion in common and external iliac arteries who were treated by endovascular methods after clinical and radiological diagnosis, and therefore to contribute to the relevant literature especially about the approach to the total occlusions in the iliac arteries by means of radiological intervention. Material and Method: We retrospectively reviewed the medical records of 21 patients (3 females, 18 males) with total occlusion of common and external iliac arteries who were admitted to our interventional radiology unit between December 2012 and September 2018. Primary stenting and percutaneous transluminal angioplasty in case of need, were performed in 20 patients in whom endovascular treatment was decided and the iliac lesions could be passed. Patients were followed up by the evaluation of clinical findings and utilizing color Doppler ultrasound on the 1st, 3rd, 6th and 12th months, and by CT angiography or digital subtraction angiography when further examinations were required. Results: A total of 21 patients with total occlusion of common iliac (57%, n=12), external iliac (14%, n=3), both common and iliac (29%, n=6) arteries were evaluated according to the TASC (TransAtlantic InterSociety Consensus) II classification, and 66.7% (n=14) of the patients were classified as type B, 4.8%(n=1) as type C and 28.6%(n=6) as type D. The mean occluded segment length was measured as 8.19 mm (range: 3-17 mm). A total of 35 stents (32 balloon expandables, 3 self expandables) were used in 20 patients and percutaneous transluminal angioplasty was performed in 12 patients due to residual stenosis. Technical success rate in endovascular treatment was calculated as 95.2% (n=20). The mean follow-up period for 20 patients was 60.6 months (range: 1-68 ay). Primary patency rates for 1, 3 and 5 years were calculated as 91.6%, 71.4%and 50%, respectively. Conclusion: The technical success and patency rates of stent placement and percutaneous transluminal angioplasty in the iliac region are high and it is expected that these rates will increase with the development of existing materials, approach techniques and the experience of the centers applying them