Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Long-Term Clinical Outcomes of Iliac Artery Endovascular Therapy in the Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases (K-VIS ELLA) Registry

  • Ji Woong Roh (Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine and Cardiovascular Center, Yongin Severance Hospital) ;
  • Sanghoon Shin (Department of Cardiology, Ewha Womans University Medical Center, Ewha Womans University) ;
  • Young-Guk Ko (Department of Cardiology and Cardiovascular Research Institute, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Nak-Hoon Son (Division of Biostatistics, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Chul-Min Ahn (Department of Cardiology and Cardiovascular Research Institute, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Pil-Ki Min (Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Jae-Hwan Lee (Division of Cardiology, Chungnam National University Sejong Hospital) ;
  • Chang-Hwan Yoon (Division of Cardiology, Seoul National University Bundang Hospital) ;
  • Cheol Woong Yu (Division of Cardiology, Korea University Anam Hospital) ;
  • Seung Whan Lee (Division of Cardiology, Asan Medical Center, Ulsan University College of Medicine) ;
  • Sang-Rok Lee (Division of Cardiology, Jeonbuk National University Hospital) ;
  • Seung Hyuk Choi (Division of Cardiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • In-Ho Chae (Division of Cardiology, Seoul National University Bundang Hospital) ;
  • Donghoon Choi (Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine and Cardiovascular Center, Yongin Severance Hospital)
  • Received : 2021.11.30
  • Accepted : 2022.03.10
  • Published : 2022.07.01
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Abstract

Background and Objectives: Limited data are available regarding long-term clinical outcomes of iliac artery endovascular therapy (EVT) in real-world practice. This study investigated long-term outcomes according to Trans-Atlantic Inter-Society Consensus (TASC) classifications. Methods: We analyzed data from 1,705 limbs of 1,364 patients from the retrospective cohort of the multicenter Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Disease registry. The primary endpoint was target lesion revascularization (TLR)-free survival. Results: TASC A, B, C, and D lesions were present in 19.4%, 26.2%, 28.7%, and 25.7% of the treated limbs, respectively. The technical success rate was 96.2% and did not differ between TASC lesion types. Complications occurred in 6.8% of cases and more occurred in TASC D (11.8%). Iliac artery EVT showed a 5-year TLR-free survival of 89.2%. The TASC D group had the lowest TLR-free rate of 79.3%. TASC D (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.12-2.73; p=0.014), plain old balloon angioplasty (HR, 4.25; 95% CI, 2.03-8.88; p<0.001), current smoker (HR, 1.89; 95% CI, 1.26-2.83; p=0.002), previous bypass surgery (HR, 3.04; 95% CI, 1.28-7.19; p=0.011), combined femoropopliteal treatment (HR, 4.89; 95% CI, 3.19-7.50; p<0.001), combined below the knee treatment (HR, 2.20; 95% CI, 1.25-3.89; p=0.007), and complications (HR, 1.86; 95% CI, 1.07-3.24; p=0.028) were predictors for TLR. Conclusions: Iliac artery EVT achieved excellent technical success and 5-year TLR-free survival. TASC D showed a favorable but lower 5-year TLR-free survival rate and higher complication rate compared with other TASC groups.

Keywords

Acknowledgement

This research was supported by grants from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI) and a grant of Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea (HC20C0081), the Korea Medical Device Development Fund funded by the Korean government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety) (202011B29-03, 202011D12-02) and the Cardiovascular Research Center (Seoul, Korea).

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