103 Impacts of Stent Choice on Long-Term Outcomes of Primary Iliac Stents: A Single-Centre Retrospective Cohort Study

Abstract Introduction Endovascular management of iliac arterial disease can be challenging, and outcomes varied. Stenting is a common intervention, however, can remain problematic. The type of stent used, covered vs. uncovered or balloon-expanding vs. self-expanding, may influence outcomes. Methods 265 patients (389 stents) that underwent iliac stent insertion between January 2015 and September 2023, were included. Primary outcomes were restenosis, major adverse limb events (MALE), and all-cause mortality. Multivariate Cox proportional hazards models and Kaplan-Meier survival analysis were used for analysis. Results 63 patients (113 stents) vs 202 patients (276 stents) received covered vs. uncovered stents, respectively. The average total stent length was 53 (22-207) mm. Average age was 68.8 (38-94) years, and 67.9% were male. Median follow up was 4.7 (0.2-9) years. Restenosis rate was 10.0% (39 stents), and MALE occurred in 23.0% (61 patients). The mortality rate was 21.1% (56 patients). Covered stents were significantly associated with restenosis [HR = 4.226, 95% CI [3.253, 5.489], p < 2 x 10-16], MALE [HR = 3.23, 95% CI [2.51, 4.15], p < 2 x 10-16], and mortality [HR = 5.31, 95% CI [4.05, 6.95], p < 2 x 10-16] compared to uncovered stents. Conclusion Our unit has demonstrated excellent primary patency rates following iliac stent insertion. Enhanced monitoring and tailored interventions, particularly in patients receiving covered stents, are crucial to further improving long-term outcomes. Optimising medical management across all stent types may also have a significant impact on restenosis, MALE and survival rates, underscoring the need for comprehensive patient care strategies.