Cooperative Strategy in Vascular Disease : Vascular surgeons and interventional radiologists

ABSTRACT

Endovascular technologies have intrinsic appeal to patients and physicians, they may, if proved safe and effective, replace a substantial proportion of current vascular surgical procedures. Because the developement and the use of these technologies require the skills and the talents of the vascular surgeons and interventional radiologists, a collaborative, multispecialty approach to the use of endovascular technologies is recommended as the most reasonable and optimal treatment for patient care. The purpose of this article is to review our experiences with cooperative endovascular treatments in vascular disease and to stress the key role of vascular surgeon on these technologies. From July, 1995 to March, 1998, 7 cooperative endovascular treatments were done in six patients. Male to female ratio was 4:2 and median age was 58.0 yrs (40~71 yrs). All procedures were done in angiography suite under the local anesthesia. Indications for treatments were 3 pseudoaneurysms in Behcet's disease, 2 abdominal aortic aneurysms (AAAs), 2 acute arterial occlusions with ASO. Six stent graftings were done for aneurysmal diseases. Recurred pseudoaneurysm was occurred in one patient with Behcet's disease, and stent graft was reinserted. Postoperative leak was seen in one patient with AAA, but sealed up spontaneously on following angiography. Simultaneous endovascular balloon angioplasty with open thrombectomy were done in 2 acute arterial occlusions with ASO. Vascular surgeons and interventional radiologists executed cooperative, team approaches in all procedures with success. Although this approach may not be applicable for every vascular disease, vascular surgeons must represent the leadership of the this cooperative treatment. For this, sufficient knowledge and training program with active participation in these technologies are necessary.