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Thromboendarterectomy for obstructive disease of the common iliac artery
J Oskam1, J J van den Dungen, A H Boontje
1Department of Surgery, University Hospital Groningen, The Netherlands.
Insights
Thromboendarterectomy of the common iliac artery is a safe and effective procedure for treating obstructive disease. This study shows good long-term results and symptom relief for patients with claudication.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Peripheral Artery Disease
Background:
- Atherosclerotic obstructive common iliac artery disease affects numerous patients, often leading to debilitating symptoms like claudication or rest pain.
- Bilateral disease is common, impacting surgical decision-making and outcomes.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of semiclosed thromboendarterectomy for common iliac artery disease.
- To assess the impact of the procedure on ankle-brachial pressure index and patient symptomatology.
Main Methods:
- Retrospective case study of 94 patients undergoing 163 semiclosed common iliac artery endarterectomies between 1971 and 1990.
- Median follow-up of 7 years, analyzing pre- and post-operative ankle:brachial pressure index, symptom resolution, and patency rates.
Main Results:
- Significant improvement in mean ankle:brachial pressure index from 0.66 to 0.98.
- Complete symptom resolution in all patients experiencing claudication.
- Low postoperative morbidity and no mortality.
- Primary cumulative patency rates of 83% at 5 years and 68% at 10 years.
Conclusions:
- Common iliac artery thromboendarterectomy is a safe procedure with minimal complications.
- The procedure offers good long-term results and is an effective treatment for common iliac artery stenosis or occlusion.
Abstract:
A retrospective case study was carried out from 1971-1990, with a median follow-up of 7 years, to assess the long-term results of thromboendarterectomy of the common iliac artery. The study included 94 consecutive patients, median age 52 years, of whom 84 suffered from atherosclerotic obstructive common iliac disease causing claudication, and 10 suffered from rest pain. Bilateral disease was present in 67 patients, and unilateral disease in 27. A total of 163 semiclosed endarterectomies (with the ringstripper) were performed. The mean ankle:brachial pressure index rose from 0.66 to 0.98. All patients with claudication became symptom-free after endarterectomy. Postoperative morbidity was low and there was no postoperative mortality. Recurrent aortoiliac symptoms were seen in 25 patients, leading to aortobifemoral bypass grafting in 12 cases. The primary cumulative patency rate at 5 and 10 years was 83% and 68% respectively. Thromboendarterectomy of the common iliac artery is a safe procedure with few complications and good long-term results. It is an effective method of treating common iliac artery stenoses or occlusions.