Factors affecting primary patency of stenting for TransAtlantic Inter-Society (TASC II) type B, C, and D iliac occlusive disease

Background and objective: The purpose of our study was to evaluate 1- and 2-year results and the influence of risk factors on the outcome in the patients undergoing iliac artery stenting for TASC II type B, C, and D iliac lesions.
Materials and methods: In this prospective nonrandomized study conducted between April 15, 2011, and April 15, 2013, 316 patients underwent angiography with a diagnosis of aortoiliac atherosclerotic disease. Of these, 62 iliac endovascular procedures (87 stents) were performed in 54 patients.
Results: The indications for revascularization were disabling claudication (Rutherford 2, 5.9%; Rutherford 3, 35.2%), rest pain (Rutherford 4, 22.2%), and gangrene (Rutherford 5, 16.7%). The overall complication rate was 9.2%. The cumulative primary stent patency at 1 and 2 years was 83.0% ± 5.2% and 79.9% ± 5.8%, respectively. Early stent thrombosis in ≤30 days was detected in two patients (3.7%). The primary patency rates for the stents ≤61 mm at 12 and 24 months were 90.6% ± 4.5% and 86.6% ± 5.8%, respectively; those for the stents >61 mm were 67.7% ± 10.9% and 60.2% ± 12.0%, respectively (P = 0.016). The multivariate Cox regression analysis enabled the localization of a stent in both the CIA and the EIA (hazard ratio [HR], 3.3; 95% confidence interval [CI], 1.1–9.5; P = 0.021) and poor runoff (HR, 3.2; 95%, CI 1.0–10.0; P = 0.047) as independent predictors of decreased stent primary patency.
Conclusions: The localization of a stent in both iliac (CIA and EIA) arteries and poor runoff significantly reduce the primary stent patency. Patients with stents >61 mm have a higher risk of stent thrombosis or in-stent restenosis development.