Use of intravascular ultrasound improves long-term clinical outcome in the endovascular management of atherosclerotic aortoiliac occlusive disease

Abstract Purpose: This study was undertaken to determine whether the use of intravascular ultrasound (IVUS) during balloon angioplasty and stenting of atherosclerotic aortoiliac occlusive lesions improved long-term clinical outcome. IVUS has been previously shown to be more accurate than arteriography in evaluating the deployment of stents in both peripheral and coronary arteries. Incomplete stent deployment has been anecdotally identified as a cause of restenosis or occlusion of a treated lesion. To our knowledge, there have been no previous studies that demonstrate whether the use of IVUS will affect the long-term patency rate of stented arterial lesions. Methods: Between March 1992 and October 1995, 52 patients with symptomatic aortoiliac occlusive disease underwent balloon angioplasty and stenting of their lesions. We retrospectively reviewed these cases to determine whether the use of IVUS influenced the long-term patency rate of these interventions. Follow-up ranged from 1 to 4 years with a mean of 28 months. Results: Fifty-two patients had confirmation of adequate stent deployment by arteriography. IVUS was used in conjunction with arteriography in 36 patients to evaluate stent deployment. Patients in the IVUS-assisted group were slightly younger than those patients who were evaluated solely by arteriography ( p p Conclusions: The use of IVUS may be the best means for assessing adequacy of arterial stent deployment. Our study suggests that the use of IVUS improves the long-term clinical outcome of balloon angioplasty and stented aortoiliac occlusive lesions. (J Vasc Surg 1998;27:614-23.)