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Endovascular therapy for long-segment atherosclerotic aortoiliac occlusion

Liangxi Yuan1, Junmin Bao1, Zhiqing Zhao1

  • 1Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China.

Journal of Vascular Surgery
|November 19, 2013
PubMed

Insights

Endovascular therapy, including stenting and catheter-directed thrombolysis (CDT), is a feasible treatment for long-segment aortoiliac occlusion. This approach demonstrated high technical success and favorable midterm patency with low complication rates.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Interventions

Background:

  • Long-segment atherosclerotic aortoiliac occlusion poses a significant challenge in vascular treatment.
  • Endovascular therapy offers a less invasive alternative to traditional surgical methods.

Purpose of the Study:

  • To investigate the outcomes of endovascular therapy for long-segment atherosclerotic aortoiliac occlusion.
  • To evaluate the technical success, complication rates, and midterm patency of these interventions.

Main Methods:

  • Retrospective analysis of 20 patients with long-segment aortoiliac occlusion (>10 mm) treated between May 2008 and January 2013.
  • Procedures included stent implantation, with or without catheter-directed thrombolysis (CDT), percutaneous transluminal angioplasty (PTA), and stenting via brachial or femoral artery puncture.

Main Results:

  • Technical success rate was 95% (19 of 20 patients).
  • No in-hospital mortality was observed; one patient experienced retroperitoneal hemorrhage.
  • Significant improvement in postoperative ankle-brachial indexes and clinical Rutherford categories was noted.
  • Primary patency rates were 93.3% at 6 months, 83% at 18 months, and 66.4% at 24 months.

Conclusions:

  • Endovascular therapy is a feasible option for complete long-segment infrarenal aortic occlusion.
  • The combined approach of PTA, stenting, and CDT offers lower complication rates.
  • Favorable midterm patency rates support the use of endovascular interventions in selected patients.
Abstract

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