ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Iliac stent patency in oncologic patients with peripheral artery disease treated by femoral endarterectomy and iliac stenting


Introduction. Patients with peripheral artery disease and oncological comorbidities often face severe forms of the disease, with an increased risk of amputation and perioperative mortality. Femoral endarterectomy followed by iliac stenting is an alternative to aorto-femoral bypass with reduced perioperative risks. Despite successful revascularization, oncologic patients experience lower patency rates.
The objective of the study was to identify the factors responsible for lower iliac stent patency rates in oncologic patients.
Material and methods. We investigated 74 patients with severe iliac artery lesions and complete occlusion of the common femoral artery, who were divided into two groups: 25 patients with associated oncologic pathology and 49 non-oncologic patients. Subsequently, two subgroups were created for each group, to evaluate the impact of heart failure with impaired ejection fraction on stent patency. All patients underwent common femoral artery endarterectomy followed by iliac stenting. The patency of iliac stents after one-year was assessed by Doppler ultrasound, and statistical analysis was performed using Kaplan-Meier survival curves.
Results. Oncologic patients had a lower one-year iliac stent patency rate (66.48%) compared to the control group (85.66%). Additionally, patients with impaired left ventricular ejection fraction (< 40%) were more prone to experiencing iliac stent occlusion after one year, particularly in the oncologic group (53.43% patency). Moreover, the oncologic group also exhibited a notably higher incidence of postoperative thrombosis.
Conclusions. Our study highlights a greater occurrence of postoperative thrombotic complications in oncologic patients. Moreover, heart failure with reduced ejection fraction could be a potential contributor to early stent occlusion.
Keywords: hybrid vascular surgery, oncologic patients, peripheral artery disease, mid-term patency, amputation-free survival.

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Address for correspondence:
Cristian T. PAIUS
Emergency Surgery Unit, St. Pantelimon Emergency Clinical Hospital, Bucharest, Romania
Address: Sos. Pantelimon, no. 340-342, Sector 2, Bucharest, Romania
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Paius CT, Constantin VD, Carap A, Halpern R, Tarus A, Tinica G. Iliac stent patency in oncologic patients with peripheral artery disease treated by femoral endarterectomy and iliac stenting. Arch Balk Med Union. 2023;58(2):141-149.