Internal iliac artery angioplasty and stenting: an underutilized therapy

Abstract

Background: Internal iliac artery (IIA) stenosis is a common finding in patients undergoing angiography. In patients with localized thigh and buttock claudication, endovascular treatment of an isolated IIA stenosis may lead to symptomatic improvement.

Methods: We retrospectively reviewed the records of nine patients who underwent IIA intervention for symptomatic thigh/buttock claudication. Patient demographics, angiographic status of both IIAs, and technical success were assessed by chart and angiogram review. Symptom relief was considered a successful outcome.

Results: Nine patients underwent unilateral or bilateral IIA angioplasty and/or stenting. There was a 100% technical success rate, and there were no complications. Six patients underwent a bilateral intervention and three underwent unilateral intervention. Fifteen arteries were treated. Seven arteries were treated with angioplasty, two with angioplasty and stenting, and six with primary stenting. Of the nine patients treated, seven had symptomatic relief from their claudication. Mean follow-up was 1 month.

Conclusion: Percutaneous angioplasty and stenting of the IIA is technically feasible and safe. In patients who present with isolated proximal thigh and buttock claudication, IIA occlusive disease should be considered as an etiology. A majority of patients undergoing intervention report symptomatic improvement. Percutaneous intervention of the IIA has not been reported previously and should be an endovascular treatment option given its low morbidity and success rate. Also, there may be a beneficial role for IIA intervention in those patients undergoing unilateral IIA embolization during the course of endovascular aneurysmorrhaphy.