ACR Codes: 9.7
Most iliac artery stenoses are amenable to balloon angioplasty. Hemodynamically significant focal, uncalcified stenoses <5cm long and eccentric or calcified stenoses<3 cm long are clear indications for angioplasty. The results of iliac artery stent placement are somewhat better than for balloon angioplasty alone. If a stent is placed up to the aortic bifurcation, it is prudent to at least keep a guidewire across the contralateral iliac artery in the unlikely event that this vessel becomes dissected or ocluded during stent deployment. Bilateral aortic bifurcation disease is managed with "kissing stents". Complications occur in about 10% of cases and include puncture site injuries, acute stent thrombosis, distal embolization stent dislodgment, pseudoaneurysm formation, and vessel rupture.
Reference(s): Vascular and Interventional Radiology, Valji, Karim; W.B. Saunders Company, 1999, pp. 109-110