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Review
. 2016 Mar 29:12:117-27.
doi: 10.2147/VHRM.S98721. eCollection 2016.

Endovascular revascularization for aortoiliac atherosclerotic disease

Vikas Aggarwal  1 , Stephen W Waldo  2 , Ehrin J Armstrong  2
Affiliations
Review

Endovascular revascularization for aortoiliac atherosclerotic disease

Vikas Aggarwal et al. Vasc Health Risk Manag. .

Abstract

Atherosclerotic iliac artery disease is increasingly being treated with endovascular techniques. A number of new stent technologies can be utilized with high long-term patency, including self-expanding stents, balloon-expandable stents, and covered stents, but comparative data on these stent types and in more complex lesions are lacking. This article provides a review of currently available iliac stent technologies, as well as complex procedural aspects of iliac artery interventions, including approaches to the treatment of iliac bifurcation disease, long segment occlusions, choice of stent type, and treatment of iliac artery in-stent restenosis.

Keywords: balloon expandable stent; claudication; covered stent; endovascular; iliac artery; peripheral artery disease; self expanding stent.

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Figures

Figure 1
Figure 1
Balloon-expandable stent placement for treatment of bilateral common iliac artery disease. Notes: (A) The right common iliac artery is occluded near the ostium, with moderate disease of the left common iliac artery origin. (B) The occlusion was crossed antegrade, using a Simmons 1 catheter and a straight–stiff glidewire. (C) Bilateral kissing balloon angioplasty was performed for predilation. (D) Bilateral balloon-expandable stents were placed in the common iliac arteries, with a short self-expanding stent extended into the right external iliac artery.
Figure 2
Figure 2
Self-expanding stent placement for treatment of an occluded external iliac artery. Notes: (A) The right external iliac artery is occluded, with reconstitution in the distal artery near the origin of the common femoral artery. There is also significant stenosis at the origin of the right internal iliac artery. (B) The occlusion was crossed antegrade. Balloon angioplasty of the internal iliac artery origin was performed to minimize the chance of internal iliac artery occlusion. (C) A self-expanding stent was placed across the external iliac artery. (D) Final angiography demonstrated excellent angiographic result with preservation of the internal iliac artery origin.
Figure 3
Figure 3
Revascularization of aneurysmal common iliac arteries with covered stents. Notes: (A) The bilateral common iliac arteries demonstrate both significant stenosis and aneurysmal dilatation. (B) The left internal iliac artery was treated with coil embolization, and bilateral covered stent placement resulted in excellent angiographic result and exclusion of the common iliac artery aneurysms.
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