In Reply to: Case 497_02 -- Pressure gradients and clinical outcome posted by Editor on April 18, 1997 at 11:18:50:
It is surprising and hard to explain the constellation of findings. It is always easiest to point to the patient as the weakest link--i.e. symptomatic improvement after the procedure included some 'placebo' effect, though I doubt that's true. I expect the result speaks more to the innacuracy of the non-vasive measurements. I wonder also whether IVUS might have deomnstrated more significant iliac disease that was relatively difficult to demonstrate angiographically.
This type of disease--long segment iliac-- is an area that is certainly worth heavily investigating. The role of bare stents in the so-called "percutaneous aorto-bifem" is wide open to both possibilities and controversy.