0845_Murphy.pdf

1、Data to Know When Performing Iliac Artery InterventionsEVS 2025J.Luke Murphy,MD,FACCAssistant Director,Cardiac Cath LabMount Sinai Queens,Astoria NYConflicts Nothing to discloseCase Presentation68 M with HTN,HLD,former smoker,known PAD with prior interventions but details unknown sent for PAD evalua

2、tion prior to podiatric surgeryTo interview admits to severe bilateral claudication with 10mmHg across segment)43%of pts randomized to PTA underwent stenting at primary procedure 6-8 year patency:83%primary stenting 74%selective stenting(NS)Reintervention,ABI,QOL not significantly differentConsidera

3、tions in Aorto-iliac Disease:PTA vs.StentingMeta-analysis Bosch et al.Radiology 1997;204:87-96What kind of stent?Clinical questionDataEndovascular treatment vs.SurgicalObservational/RCT/Meta-analysisPTA vs.StentingRCT(Dutch Iliacs)Covered vs.Bare metal stentsRCT(Cobest Trial,DISCOVER Trial)Self-expa

4、nding vs.Balloon expandableRCT(ICE Trial)Lesion modificationObservationalSpecial techniquesObservationalDCBMinimalDESMinimalConsiderations in Aorto-iliac Disease:Covered vs.Bare Metal Stents Bibombe et al.J Vasc Surg 2016;64:83-94 COBEST trial 5 year data N=125 pts with aortoiliaclesions Covered ste

5、nt(CS)vs.bare metal stents(BMS)77 pts followed to 5 years CS with improved patency at 5 years No difference in amputationsPiazza et al.Eur J Vasc Endovasc Surg(2017)54,177e185Considerations in Aorto-iliac Disease:Covered vs.Bare Metal Stents Considerations in Aorto-iliac Disease:Covered vs.Bare Meta

6、l Stents DISCOVER Trial,2023,RCT174 Limbs,Common Iliac artery stenosisRandomized to balloon-expandable CS vs.BMS 6 patients crossed over BMS CS No difference in binary restenosis,occlusion,TLR at 2 years Eur J Vasc Endovasc Surg(2023)65,359e368What kind of stent(be more specific)?Clinical questionDa