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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12001/3448

 
Title :[原著]Evaluation of the usefulness of primary stenting of the iliac artery with Palmaz stent in patients with arteriosclerosis obhterans
Authors :Sakuda, Hitoshi
Nakaema, Moriyasu
Higa, Noboru
Matsubara, Shinobu
Uezu, Thoru
Shimoji, Mitsuyoshi
Miyagi, Kazufumi
Kamada, Yoshihiko
Kuniyoshi, Yukio
Koja, Kageharu
Authors affiliation :Second Department of Surgery, Faculty of Medicine, University of the Ryuhyus, Okinawa, Japan
Issue Date :2002
Publisher :琉球医学会
Type Local :雑誌掲載論文
Type (NII) :Journal Article
ISSN :1346888X
0289-1530
Abstract :We evaluated the clinical usefulness of primary stenting of the iliac arteries with Palmaz stent in patients with arteriosclerosis obliterans by analysis of early and midterm postoperative results. Between December 1997 and December 2000, we treated 16 patients of 18 ischemic lower limbs ( 16 stenoses and 2 0cclusions) including 15 men and 1 woman between 48 and 76 years of age (average 63.4 years). Primary stenting was indicated for patients with apparent ischemic symptoms (Fontaine stage of II, III and IV) and reduced ankle pressure index (API, 0.9 or less). Morphological indication was segmental lesions of the iliac artery: an occlusive lesion was 3 cm or less in length, and a stenotic lesion 60% or more in degree and 6 cm or less in length. The stented lesions were located in the common iliac artery in 6 limbs, in the external iliac artery in 7 limbs, and in both arteries in 5 limbs. The 5 patients with multiple arterial occlusive disease underwent simultaneous iliac stent placement and infrainguinal open surgery. Initial technical and clinical success of zero or less than 10% residual stenosis was achieved in all patients (100% initial success rate). A minor complication was noted in 1 patient (5.6%), a small pseudoaneurysm at the punctured site of the common femoral artery that was treated successfully by compression therapy. No major complication requiring open surgery, blood transfusion or perioperative death occurred in any of our patients. Mean API increased significantly from 0.59 ±0.23 preoperatively to $0.95 \pm 0.17$ postoperatively (p<0.01). Clinical symptoms improved in all patients except 1. During the follow-up period of 2 to 46 months (average 21 months), 2 high-risk patients died from cerebral hemorrhage, 1 at 5 months and the other at 22 months after stenting. A stented artery in the primary thrombocytosis patient, who received stents for distal anastomotic stenosis of an aortobi-iliac synthetic bypass, occluded after 2 months and was treated by axillofemoral bypass. In a patient with diffuse atherosclerosis of the iliac artery, a severe 75% stenosis recurred within the stent and its distal artery, which was successfully treated by re-stenting. The 3-year primary cumulative patency rate in total patient series was 88.5%, and secondary rate was 94.4%. Although further follow-up studies are needed to evaluate long-term efficacy, our current results indicated that primary stenting for segmental iliac lesions is safe, minimally invasive, and as functional as conventional open surgery.
Rights :琉球医学会
URI :http://hdl.handle.net/20.500.12001/3448
Citation :琉球医学会誌 = Ryukyu Medical Journal Vol.21 no.1 p.29 -33
Appears in Collections:Ryukyu Medical Journal

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