Luminal changes in downsteam arteries after percutaneous interventions in iliac arteries: implications for balloon or stent size determination.

PURPOSE

To evaluate changes in the diameter of downstream iliac arteries after percutaneous interventions, which may be important for stent or balloon size determination.

PATIENTS AND METHODS

Angiographic studies were reviewed respectively for 31 patients in whom a unilateral common iliac artery occlusion (n = 10) or a high-grade stenosis (> 75%; n = 21) was treated with stent implantation (26 patients) or balloon angioplasty (five patients).

RESULTS

Before intervention, the ipsilateral downstream arteries showed a luminal reduction in 26 of 31 patients (mean 24% +/- 11.0; range, 6%-64%) compared with the opposite artery. This side-to-side difference was statistically significant for the external iliac artery (P = .000007) and for the common iliac artery distal to the obstruction (P = .017). In 17 of 26 patients, the side-to-side difference of the downstream external iliac artery was fully reversible immediately after intervention. In five patients, a luminal widening was noted. No change was seen in only four patients.

CONCLUSION

Because downstream arteries often show a marked luminal widening after intervention, determination of balloon or stent size cannot be based solely on the diameter of downstream ("normal") ipsilateral artery before intervention.