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10년간의 3차 의료기관 경험을 바탕으로 한 대동맥장골동맥 폐색 질환 혈관내 치료의 기술적 고찰: 후향적 연구.

Panat Nisityotakul1, Sorracha Rookkapan1

  • 1Department of Radiology, Vachira Phuket Hospital, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

Journal of the Korean Society of Radiology
|June 14, 2024
PubMed
Summary
This summary is machine-generated.

Endovascular treatment for aortoiliac occlusive disease (AIOD) showed lower success for complex TASC C & D lesions. Simultaneous femoral and brachial approaches improved recanalization rates in challenging AIOD cases.

Keywords:
Aortoiliac Occlusive DiseasePeripheral Vascular DiseaseTechnical ConsiderationsTransatlantic Inter-Society Consensus

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Interventions

Background:

  • Aortoiliac occlusive disease (AIOD) is a significant cause of peripheral artery disease.
  • Endovascular treatment offers a less invasive approach for AIOD management.
  • Technical considerations and outcomes of AIOD endovascular treatment require ongoing evaluation.

Purpose of the Study:

  • To evaluate the technical aspects and outcomes of endovascular treatment for aortoiliac occlusive disease (AIOD).
  • To analyze a 10-year experience with AIOD endovascular interventions at Songklanagarind Hospital.
  • To assess the impact of lesion complexity (TASC classification) on procedural success.

Main Methods:

  • Retrospective cohort study of 210 patients with symptomatic AIOD undergoing endovascular treatment (2010-2020).
  • Data collection included clinical and lesion characteristics, and procedural technical considerations.
  • Analysis and stratification of outcomes based on the Transatlantic Inter-Society Consensus (TASC) classification.

Main Results:

  • Most patients (80%) presented with chronic limb-threatening ischemia.
  • Technical success rates were significantly higher for TASC A & B lesions (99.2%) compared to TASC C & D (84.4%).
  • The femoral-brachial approach showed a higher technical success rate (93.3%) for TASC C & D lesions than the unibifemoral approach (89.0%), despite higher complication rates (17.6%).

Conclusions:

  • Simultaneous femoral and brachial approaches can enhance technical success in complex TASC C & D AIOD cases with failed femoral access.
  • Careful consideration of access strategies is crucial for optimizing endovascular treatment outcomes in AIOD.
  • Minimally invasive or conservative management of access site complications is feasible.