Early experience with the Palmaz expandable intraluminal stent in iliac artery stenosis.

Since 1987, we have used the Palmaz expandable intraluminal stent in 22 selected cases of iliac artery stenosis in 14 men and six women with a mean age of 63 years for claudication (9), graft salvage (5), rest pain (4), and tissue loss (2). Morphologic criteria included severe percutaneous balloon angioplasty-induced dissection (6), long or multiple stenoses or occlusions (5), post-percutaneous balloon angioplasty elastic recoil (4), location of stenosis (4), and restenosis following percutaneous balloon angioplasty (3). Twenty-two limbs were treated with 61 stents. The mean pressure gradient across the lesion fell from 31 +/- 15 to 1.1 +/- 2.4 mmHg after stenting. The mean ankle/brachial systolic pressure index improved from 0.59 +/- 0.31 to 0.83 +/- 0.25 after stenting. The mean follow-up is 11.4 months, with a mean ankle/brachial index at their most recent follow-up of 0.88 +/- 0.19. Symptomatically, 11 extremities are normal and five limbs are improved. Three patients have died and two have required bypass grafts for iliac occlusive disease. In this early experience, the Palmaz intraluminal stent appears to be valuable for the management of post-percutaneous balloon angioplasty restenosis, elastic recoil, and percutaneous balloon angioplasty-induced dissection, although it is not without complications.