by Ken Dropiewski, Prime-Core Executive Search (ken@prime-core.com)
Balloon expandable stents have been the mainstay in treating blockages in the iliac arteries for years. However, recent data suggests a change is in order. According to researchers who recently compared the two versions in a large group of patients being treated in northern Europe, found that self-expanding (SE) stents proved more effective and are recommended for patients with iliac stenosis. The study was published this week in the Journal of the American College of Cardiology.
Endovascular stenting approaches, regardless, are still preferred to surgery and balloon angioplasty as a treatment of iliac lesions. The recent study just answers the question, “Which is the best type of stent to use?”
The Study
“The treatment of iliac artery occlusive disease with SE led to a decreased incidence of restenosis at 12 months and thus provided superior primary patency than the treatment with BE,” says Hans Krankenberg, study director.
Findings were based on data from 660 patients enrolled into a cohort study between August 2010 and June 2013 across 18 Swiss and German medical centers. Each selected patient had a diagnosis of peripheral artery disease with symptoms. The lesions, which did not extend into the aorta or common femoral artery grades 1 to 4 and a single external or common iliac artery lesion between 10mm and 200mm in length. The two treatment groups were matched in terms of the nature and symptoms of the targeted lesions and any co-morbidities, risk factors, and coexisting conditions.
Key Findings
The key finding indicated that restenosis occurred in around 6 percent of the patients treated with self-expanding stents compared to nearly 14 percent of the patients receiving balloon expanding stents.
BE Stents Still Have Their Place
The data clearly suggests that self-expanding stents provide a more favorable outcome for patients with blockages in both the common iliac and external iliac arteries. However, this doesn’t mean that they are the best choice for all patients. One area where balloon expanding stents are still favorable in treating vessels with more complicated anatomical features such as those with tortuous or twisted vessels. This may be due to the fact that the force created from the balloon has a straightening effect due to the sheer force.
