Strecker E P, Boos I B, Hagen B
Department of Radiology, Diakonissen Hospital, Karlsruhe, Germany.
Radiology. 1996 Jun;199(3):641-7. doi: 10.1148/radiology.199.3.8637980.
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.
评估钽支架植入髂动脉病变的长期成功率，并确定早期和晚期支架失败的潜在预测因素。
289例患者中，将可弯曲钽支架植入髂动脉狭窄（n = 223）或闭塞（n = 66）病变处。在1至79个月（平均23个月）评估早期和晚期支架失败情况。评估四个危险因素：病变类型（闭塞与狭窄）、病变部位（髂总动脉与髂外动脉）、病变长度（<4 cm与>4 cm）以及侧支循环质量（良好与不佳）。
闭塞病变（15.2%）的早期支架血栓形成频率显著高于狭窄病变（2.7%）（P <.001），髂外动脉（12.8%）高于髂总动脉（1.1%），长病变（16.7%）高于短病变（0.5%），侧支循环不佳（14.0%）高于良好（2.1%）。多因素分析显示，侧支循环和病变部位是影响因素。所有支架3年和5年的原发性通畅率分别为85%和70%。短病变（88%）的3年通畅率显著高于长病变（63%），狭窄病变（92%）高于闭塞病变（63%）。多因素分析显示，病变长度是3年支架通畅的唯一预测因素。
支架植入为动脉粥样硬化性髂动脉疾病提供了有价值的长期治疗方法。可根据危险因素预测成功率。
