In those patients with critical iliac aterosclerotic lesions, limiting claudication, pain at rest, limiting lifestyle and despite medical treatment shows no improvement .
Covered stents can afford a protective mechanism that shields stents from tissue in-growth and may reduce restenosis caused by intimal hyperplasia?
They may offer an improvement in performance in the treatment of more complex iliac disease?
Dear Paulo
These articles may be useful for you
.
1) New treatment of iliac artery disease: focus on the Absolute Pro® Vascular Self-Expanding Stent System.
Gates L1, Indes J.
Med Devices (Auckl). 2013 Sep 13;6:147-150. eCollection 2013
2) DISCOVER: Dutch Iliac Stent trial: COVERed balloon-expandable versus uncovered balloon-expandable stents in the common iliac artery: study protocol for a randomized controlled trial.
Bekken JA1, Vos JA, Aarts RA, de Vries JP, Fioole B.
Trials. 2012 Nov 19;13:215..
3) Internal iliac artery angioplasty and stenting: an underutilized therapy.
Thompson K, Cook P, Dilley R, Saeed M, Knowles H, Terramani T, Kansal N.
Ann Vasc Surg. 2010 Jan;24(1):23-7.
Dear Nelson Elias,
Thanks for your answer.
As new types of stents and more accurate methods of placement are introduced, it is hoped that more extensive and multifocal iliac lesions can be treated with endovascular procedures.
Stent-graft treatment of patients with severe aortoiliac occlusive disease (85% TASC types C and D lesions) was reported by Rzucidlo and colleagues. The use of stent-grafts increased the primary and primary assisted patency at 1 year to 70% and 88%, respectively, compared with patients treated with stents alone, and led to 100% early hemodynamic and clinical success.
Rzucidlo EM, Powell RJ, Zwolak RM, et al: Early results of stent-grafting to treat diffuse aortoiliac occlusive disease. J Vasc Surg 2003; 37:1175-1180.
The Covered Versus Balloon Expandable Stent Trial (COBEST), a prospective, multicenter, randomized controlled trial, was performed involving 168 iliac arteries in 125 patients with severe aortoiliac occlusive disease who were randomly assigned to receive a covered balloon-expandable stent or bare-metal stent.
COBEST demonstrates covered and bare-metal stents produce similar and acceptable results for TASC B lesions. However, covered stents perform better for TASC C and D lesions than bare stents in longer-term patency and clinical outcome.
References
1BP Mwipatayi, S Thomas, J Wong, SE Temple, et al.: A comparison of covered vs bare expandable stents for the treatment of aortoiliac occlusive disease. J Vasc Surg. 54 (6):1561-1570 2011 21906903
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