Covered versus bare metal stents in treatment of primary common iliac disease.

Background: Endovascular therapy is the preferred approach for mild-to-moderate common iliac artery (CIA) occlusive disease. Although primary stenting is a treatment option, few studies compare covered and bare metal stenting regarding short- and long-term patency.Objective: This study compares the outcomes of covered vs. bare metal stents (BMS) in CIA occlusive lesions.Methods: In this prospective cohort study (November 2022–June 2024), 40 patients with CIA occlusive disease received either BMS (n=20) or covered stents (CS) (n=20). Data were collected prospectively. The primary outcome was primary patency, while secondary outcomes included major amputations, assisted primary patency, secondary patency, major adverse limb events requiring hospitalization and death.Results: The mean ages for CS and BMS groups were 59.5 ± 6.6 and 58.2 ± 8.6 years, respectively (p=0.608). Lesion classifications (TASC II B, C, D: 35%, 55%, 10% for CS vs. 40%, 45%, 15% for BMS, p=0.828) and GLASS classifications (A1, A2: 55%, 45% for CS vs. 65%, 35% for BMS, p=0.50) were similar. Lesion lengths (short: 50% CS vs. 55% BMS; intermediate: 40% CS vs. 35% BMS; long: 10% in both, p=0.999) were evenly distributed. Major adverse limb events and complications were less frequent with CS but not statistically significant. Primary patency at one month was 100% for both groups, with sustained patency favoring CS at 6 months (100% vs. 90%, p=0.487) and 18 months (90% vs. 75%, p=0.407).Conclusion: Both stent types are technically feasible and yield acceptable outcomes. CS shows higher primary patency rates at 6 and 18 months compared to BMS.