ABSTRACT
Objective To discuss the strategies of prevention and treatment for complications of endovascular therapy in aortoiliac artery occlusive disease.Methods 220 cases who received endovascular interventions with aortoiliac artery occlusive disease were retrospectively reviewed from June 2012 to June 2014.Among these patients,189 cases were males.The age was between 46 to 85yrs and the average age was 64yrs.Results The overall technique success rate was 97.2％.Nine procedure-related major complications requiring additional endovascular or surgical treatment were encountered in 7 patients including 2 acute in-stent thrombosis,1 iliac artery rupture,1 distal embolism,and 5 puncture associated complications (2 acute artery thrombosis,1 arteriovenous fistula,1 hematoma,1 artery dissection).8 cases improved after second endovascular or remedial open surgery,among those 4 cases were managed by endovascular interventions including 2 catheter directed thrombolysis,1 cover-stent implantation and 1 balloon-based angioplasty,4 patients received open surgery including 3 thrombectomies,1 hematoma cleating.After 22 months follow-up,the primary patency,assistant-primary patency and secondary patency was respectively 90.8％,92.1％ and 99.2％.Conclusions More attentions should be paid to the complications of endovascular therapy in aortoiliac artery occlusive disease.Helpful to prevent these complications are a comprehensive evaluation of the lesions,and individualized surgical plan prior to the operations,and a careful intraoperative management.
ABSTRACT
PURPOSE: In order to establish therapeutic guidelines for TASC C & D iliac lesions, we compared outcomes of surgical and endovascular treatment. METHODS: From May 2002 to April 2007, 27 limbs of 18 patients underwent bypass operation and 23 limbs of 21 patients underwent stent placement for TASC C & D iliac lesions at Dongsan Medical Center. Age, sex, risk factor, combined diseases, clinical symptoms, treatment method, and patency rate were reviewed retrospectively. RESULTS: Technical and clinical success was achieved in all patients of the bypass group and in 95.8% of patients in the stent group. There were no complications in the surgical group, but 4 major complications in the stent group: 3 distal embolizations, and 1 arterial rupture. The primary patency rates at 6 months, 1, 2, and 3 years were all 90% in the bypass group and 95%, 89%, 89%, and 89%, respectively, in the stent group (P=0.99). The respective secondary patency rates were all 90% in the bypass group and 100%, 94%, 94%, and 94% in the stent group (P=0.56). CONCLUSION: Arterial bypass and stent placement are technically safe and effective treatment modalities in TASC C & D lesions of the iliac artery. A liberal posture to open arterial reconstruction extends the ability to treat diffuse TASC C & D lesions via endovascular means.