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Mid-term clinical outcome following endovascular therapy in patients with chronic aortic occlusion

Tomoharu Dohi1, Osamu Iida, Shin Okamoto

  • 1Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan, tomoharu.dohi@gmail.com.

Cardiovascular Intervention and Therapeutics
|March 30, 2013
PubMed

Insights

Endovascular therapy (EVT) with stenting shows promising mid-term durability for chronic aortic occlusion, with 76% primary patency at 36 months. This treatment is a safe alternative to bypass surgery for suitable patients.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Interventions

Background:

  • Endovascular therapy (EVT) is common for iliac lesions but not established for aortic occlusion due to long-term outcome uncertainty.
  • Stenting offers acceptable patency for iliac lesions, prompting investigation into its use for more complex aortic occlusive disease.

Purpose of the Study:

  • To investigate the outcomes of EVT with stenting for chronic aortic occlusion.
  • To assess the safety and mid-term durability of EVT in patients with chronic aortic occlusion.

Main Methods:

  • Single-center retrospective analysis of a prospectively maintained database.
  • Inclusion of 25 patients (24 lesions) with chronic aortic occlusion treated with EVT and stenting between 2005 and 2012.
  • Kaplan-Meier analysis used to determine patency rates based on Society for Vascular Surgery criteria.

Main Results:

  • All lesions were Trans Atlantic Inter-Society Consensus D type, with a mean length of 145 mm.
  • Initial success rate was 96%, with an 8% procedural complication rate.
  • At 36 months, primary and secondary patency rates were 76% and 94%, respectively. Five patients experienced restenosis, all managed with reintervention.

Conclusions:

  • EVT with stenting is a safe procedure for patients diagnosed with chronic aortic occlusion.
  • The procedural morbidity and mid-term durability of EVT for chronic aortic occlusion are comparable to bypass surgery up to 3 years.

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