Abstract
Background: Atherosclerotic stenosis or occlusion of the iliac arteries is a major cause of chronic lower-extremity arterial disease (LEAD). Endovascular intervention has become the preferred revascularization strategy, particularly in elderly or high-risk patients. However, the treatment of complex, heavily calcified lesions (TASC II C–D) remains challenging. The advent of covered stents, especially the balloon-expandable BeGraft stent, offers potential advantages in these scenarios.
Methods: This prospective study included 35 patients with TASC II type C–D iliac artery lesions who underwent endovascular revascularization using BeGraft covered stents at the Vietnam National Heart Institute, Bach Mai Hospital, from January 2018 to August 2020. Procedural success, periprocedural complications, and 3-month clinical and hemodynamic outcomes were assessed.
Results: The mean age was 67.3 ± 10.4 years, and 88.6% were male. Most patients had multiple comorbidities, including hypertension (82.9%) and diabetes (42.9%). Lesions were classified as TASC II D in 91.4% of cases, with total occlusion in 54.5%. The overall procedural success rate was 100%, with no stent dislodgement or edge dissection. Four cases of iliac rupture were successfully managed with covered stent placement. All patients showed marked improvement in clinical symptoms. Mean ankle–brachial index improved from 0.65 ± 0.24 at baseline to 0.87 ± 0.19 at 3 months (p < 0.05). Only one major amputation occurred during follow-up.
Conclusions: Endovascular treatment of complex iliac artery stenosis or occlusion using the BeGraft balloon-expandable covered stent is safe and effective, providing excellent procedural success and early patency. Further studies with longer follow-up are warranted to confirm these results.