Flexible tantalum stents for the treatment of iliac artery lesions: long-term patency, complications, and risk factors.

Abstract

To evaluate the long-term success of tantalum stents implanted in iliac artery lesions and to determine potential predictive factors of early and late stent failure. In 289 patients, flexible tantalum stents were implanted in iliac artery stenoses (n - 223) or occlusions (n - 66). Early and late stent failures were evaluated at 1-79 months (mean, 23 months). Four risk factors were evaluated: lesion type (occlusion vs stenosis), lesion location (common vs external iliac artery), lesion length (< 4 vs > 4 cm), and quality of runoff (good vs poor). The frequency of early stent thrombosis was significantly (P < .001) higher in occlusions (15.2%) versus stenoses (2.7%), in external (12.8%) versus common (1.1%) iliac arteries, in long (16.7%) versus short (0.5%) lesions, and in poor (14.0%) versus good (2.1%) runoff. At multivariate analysis, runoff and location were influencing factors. Primary patency rates at 3 and 5 years were 85% and 70%, respectively, for all stents. Three-year patency rates were significantly higher in short (88%) versus long (63%) lesions and in stenoses (92%) versus occlusions (63%). At multivariate analysis, lesion length was the only predictive factor for 3-year stent patency. Stent implantation offers valuable long-term treatment for atherosclerotic iliac artery disease. Success can be predicted on the basis of risk factors.