Endovascular treatment of different types of iliac occlusions—Results from an observational study
Autoři:
Vladimir Cvetic aff001; Dragan Sagic aff001; Igor Koncar aff001; Vladimir Kovacevic aff003; Oliver Radmili aff002; Zelimir Antonic aff003; Borivoje Lukic aff002; Nikola Aleksic aff003; Lazar Davidovic aff001; Djordje Radak aff001
Působiště autorů:
School of Medicine, Belgrade University, Belgrade, Serbia
aff001; Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
aff002; Institute for Cardiovascular Diseases “Dedinje”, Belgrade, Serbia
aff003
Vyšlo v časopise:
PLoS ONE 14(10)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0222893
Souhrn
Objective
The aim of this study was to evaluate the results of endovascular therapy on the treatment of different types of iliac occlusions.
Materials and methods
A bi-center prospective, non-randomized study was conducted on 100 patients (mean age 59.14 ± 8.53; 64 men) who underwent endovascular treatment of iliac occlusive disease between January 2013 and November 2017. We evaluated baseline data, procedure, and follow-up results for the entire group, and according to Trans-Atlantic Inter-Society Consensus (TASC II) classification. The majority of patients (60%) were treated for severe claudication; 56 (56%) patients had TASC B occlusions, 28 patients TASC C, and 16 patients TASC D.
Results
The mean length of the occluded segments was 61.41 ± 35.15 mm. Procedural complications developed in 6 patients (6%). Mean ankle-brachial pressure index increased from 0.40 ± 0.12 preoperatively to 0.82 ± 0.16 postoperatively. The mean follow-up was 33.18 ± 15.03 months. After 1 and 5 years, the primary patency rates were 98% and 75.1%, and the secondary patency rate was 97% respectively. Regarding occlusion complexity there were no statistical significant differences in primary patency rates (TASC B vs. C vs. D: p = 0.19). There were no statistically significant differences in primary patency rates between patients in different clinical stages, as well as between the type of stents, and location of the occlusion.
Conclusion
In our study, endovascular treatment for iliac artery occlusions proved to be a safe and efficient approach with excellent primary and secondary patency rates regardless of the complexity of occlusions defined by TASC II classification. This study is aligned with the notion that in well selected patients, endovascular therapy can be the treatment of choice even in complex iliac lesions if performed by experienced endovascular interventionists in high volume centers.
Klíčová slova:
Angiography – Aorta – Arteries – Lesions – Stent implantation – Surgical and invasive medical procedures – Vascular surgery – Surgical repair
Zdroje
1. Jongkind V, Akkersdijk GJ, Yeung KK, Wisselink W. A systematic review of endovascular treatment of extensive aortoiliac occlusive disease. J Vasc Surg 2010; 52:1376–83. doi: 10.1016/j.jvs.2010.04.080 20598474
2. Ye W, Liu CW, Ricco JB, Mani K, Zeng R, Jiang J. Early and late outcomes of percutaneous treatment of TransAtlantic Inter-Society Consensus class C and D aorto-iliac lesions. J Vasc Surg 2011; 53:1728–37. doi: 10.1016/j.jvs.2011.02.005 21609804
3. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg 2007; 45(suppl S): S5–S67.
4. European Stroke Organisation, Tendera M, Aboyans V, Bartelink L, Baumgartner I, Clément D, et al. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Disease of the European Society of Cardiology (ESC). Eur Heart J 2011; 32(22):2851–2906. doi: 10.1093/eurheartj/ehr211 21873417
5. TASC Steering Committee, Jaff MR, White CJ, Hiatt WR, Fowkes GR, Dormandy J, et al. An update on methods for revascularization and expansion of the TASC lesion classification to include below-the-knee arteries: a supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II): The TASC Steering Committee. Ann Vasc Dis 2015; 8(4):343–357. doi: 10.3400/avd.tasc.15-01000 26730266
6. Aboyans V, Ricco JB, Bartelink MEL, Björck M, Brodmann M, Cohnert T, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J 2018; 39:763–816. doi: 10.1093/eurheartj/ehx095 28886620
7. Sixt S, Alawied AK, Rastan A, Schwarzwälder U, Kleim M, Noory E, et al. Acute and long-term outcome of endovascular therapy for aortoiliac occlusive lesions stratified according to the TASC classification: a single-center experience. J Endovasc Ther 2008; 15(4):408–416. doi: 10.1583/08-2359.1 18729553
8. Bosiers M, Deloose K, Callaert J, Maene L, Beelen R, Keirse K, et al. BRAVISSIMO: 12-month results from a large scale prospective trial. J Cardiovasc Surg (Torino) 2013; 54(2):235–253.
9. Rutherford RB, Baker JD, Ernst C, Johnston KW, Porter JM, Ahn S, et al. Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg 1997; 26: 517–38. doi: 10.1016/s0741-5214(97)70045-4 9308598
10. Leville CD, KAshyap VS, Clair DG, Bena JF, Lyden SP, Greenberg RK, et al. Endovascular management of iliac artery occlusions: extending treatment to Trans Atlantic Inter-Society Consensus class C and D patients. J Vasc Surg 2006; 33:32–9.
11. Hulley SB, Cummings SR, Browner WS, Grady D, Newman TB. Designing clinical research: an epidemiologic approach. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. Appendix 6E, page 81.
12. De Vries SO, Hunink MGM. Results of aortic bifurcation grafts for aorto-iliac occlusive disease: a meta-analysis. J Vasc Surg 1997; 26:558–69. doi: 10.1016/s0741-5214(97)70053-3 9357455
13. Timaran CH, Prault TL, Stevens SL, Freeman MB, Goldman MH. Iliac artery stenting versus surgical reconstruction for TASC type B and type C iliac lesions. J Vasc Surg 2003; 38:272–8.
14. Tsetis D, Uberoi R. Quality improvement guidelines for endovascular treatment of iliac artery occlusive disease. Cardiovasc Intervent Radiol 2008;31:238–45. doi: 10.1007/s00270-007-9095-5 18034277
15. Nyman U, Uher P, Lindh M, LAindblad B, Ivancev K. Primary stenting in infrarenal aortic occlusive disease. Cardiovasc Intervent Radiol 2000; 23:97–108. doi: 10.1007/s002709910021 10795833
16. Ahn S, Park KM, Kim YK, Kim JI, Moon IS, Hong KC, et al. Outcomes of endovascular treatment for TASC C and D aorto-iliac lesions. Asian J Surg 2017; 40(3):215–20. doi: 10.1016/j.asjsur.2015.11.006 26787498
17. AbuRahma AF, Hayes JD, Flaherty SK, Peery W. Primary iliac stenting versus transluminal angioplasty with selective stenting. J Vasc Surg 2007; 46:965–70. doi: 10.1016/j.jvs.2007.07.027 17905559
18. Yuan L, Bao J, Zhao Z, Feng X, Lu Q, Jing Z. Endovascular therapy for long-segment atherosclerotic aortoiliac occlusion. J Vasc Surg 2014; 59:663–8. doi: 10.1016/j.jvs.2013.09.005 24239521
19. Kim TH, Ko YG, Kim U, Kim JS, Choi D, Hong MK, et al. Outcomes of endovascular treatment of chronic total occlusion of the infrarenal aorta. J Vasc Surg 2011; 53:1542–9. doi: 10.1016/j.jvs.2011.02.015 21515016
20. Ozkan U, Oguzkurt L, Tercan F. Technique, complication, and long-term outcome for endovascular treatment of iliac artery occlusion. Cardiovasc Interv Radiol 2010; 33:18–24.
21. Müller A, Langwieser N, Bradaric C, Haller B, Fusaro M, Ott I, et al. Endovascular treatment for steno-occlusive iliac artery disease: safety and long-term outcome. Angiology 2018; 69(4):308–15. doi: 10.1177/0003319717720052 28747061
22. Suzuki K, Mizutani Y, Soga Y, Iida O, Kawasaki D, Yamauchi Y, et al. Efficacy and safety of endovascular therapy for aortoiliac TASC D lesions. Angiology 2017; 68(1):67–73. doi: 10.1177/0003319716638005 26980775
23. Ye W, Liu CW, Ricco JB, Mani K, Zeng R, Jiang J. Early and late outcomes of percutaneous treatment of TransAtlantic Inter-Society Consensus class C and D aorto-iliac lesions. J Vasc Surg 2011; 53(6):1728–1737. doi: 10.1016/j.jvs.2011.02.005 21609804
24. Soga Y, Lida O, Kawasaki D, Yamauchi Y, Suzuki K, Hirano K, et al. Contemporary outcomes after endovascular treatment for aorto-iliac artery disease. Circ J 2012; 76:2697–704. doi: 10.1253/circj.cj-12-0492 22864278
25. Soares RA, Matielo MF, Brochado-Neto FC, Cury MVM, Costa VB, Sanjuan MCP, et al. Factors associated with outcome of endovascular treatment of iliac occlusive disease: a single-center experience. J Vasc Bras 2018; 17(1):3–9. doi: 10.1590/1677-5449.003817 29930675
26. Indes JE, Pfaff MJ, Farrokhyar F, Brown H, Hashim P, Cheung K, et al. Clinical outcome of 5358 patients undergoing direct open bypass or endovascular treatment for aortoiliac occlusive disease: a systematic review and meta-analysis. J Endovasc Ther 2013; 20(4):443–55. doi: 10.1583/13-4242.1 23914850
27. Datillo PB, Tsai TT, Garcia JA, Allshouse A, Casserly MB, et al. Clinical outcomes with contemporary endovascular therapy of iliac artery occlusive disease. Catheter Cardiovasc Interv 2012; 80:644–54. doi: 10.1002/ccd.23469 22419505
28. Papakostas JC, Chatzigakis PK, Peroulis M, Avgos S, Kouvelos G, Lazaris A, et al. Endovascular treatment of chronic total occlusions of the iliac arteries: early and midterm results. Ann Vasc Surg 2015; 29:1508–15. doi: 10.1016/j.avsg.2015.07.011 26315790
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