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

Abstract

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.