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Home > Press Center > Press Releases from 2005 Annual Meeting > Blocked leg arteries successfully treated via angioplasty and stenting

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Emily Kalata
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Patients with blocked  arteries going to the lower legs, or aorto-iliac disease, received relief from their painful symptoms when treated with endovascular procedures such as angioplasty and stenting, according to research presented by physicians at the Cleveland Clinic at the annual meeting of the Society for Vascular Surgery in Chicago.

Endovascular techniques have become the preferred way to treat complex aorto-iliac disease. Blocked, or occluded pelvic and leg arteries deprive the legs of blood and oxygen, resulting in pain and ulcers. Researchers conducted a retrospective chart review of 82 patients (92 treated limbs, total) who received endovascular treatment for blocked lower leg arteries from 1998 to 2004. Treatments included recanalization, percutaneous transluminal angioplasty (PTA) and stenting (S).

Recanalization and PTA/S (with a total of 185 stents) of blocked arteries was successful in 91 percent of 88 limbs. The mean ankle-brachial index, which is the ratio of the blood pressure in the ankle to the blood pressure in the arm, increased from 0.36 to 0.83. Several factors were associated with resolving symptoms and healing in patients: under age 60, claudication, patent superficial femoral artery, and ankle-brachial index normalization.

Three years after the procedures were done, the rates for primary and secondary patency were 77 percent and 95 percent, respectively, and limb salvage rates were 84 percent. All of the patients in the TASC-B group had improvement or complete resolution of their symptoms (100 percent) compared to the TASC-C (78 percent) and D (83 percent) groups. TASC stands for TransAtlantic InterSociety Concensus working group guidelines. PTA is considered for types A and B lesion blockages. Types C and D refer to the more complex, or totally occluded segments of the iliac arteries, and surgery is the TASC recommended procedure. However, this study showed good results for TASC C and D lesions with PTA/S alone.

The aorta, the body's main artery, splits into branches at about the level of the navel. These branches are called the iliac arteries. The iliac arteries go through the pelvis into the legs, where they divide into many smaller arteries that run down to the toes. Aortic iliac disease is considered a type of peripheral arterial disease (PAD), because it affects arteries that carry blood away from the heart to the limbs. A normal artery is smooth, but can become blocked when plaque, a sticky substance made up of cholesterol, calcium, and fibrous tissue collects inside the walls.

As more plaque builds up, it causes the arteries to narrow and stiffen, called atherosclerosis, or hardening of the arteries. This builds up interferes with blood flow in the iliac, or leg, arteries, and may cause pain. In severe cases, sores or gangrene can develop, which can result in lost limbs. Symptoms of aorto-iliac occlusive disease are pain, cramping, or fatigue in the lower body when walking or exercising.