Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Technical Consideration of Endovascular Treatment for Aortoiliac Occlusive Disease Based on a 10-Year Tertiary Hospital Experience: A Retrospective Study

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

  • Panat Nisityotakul (Department of Radiology, Vachira Phuket Hospital, Faculty of Medicine, Prince of Songkla University) ;
  • Sorracha Rookkapan (Department of Radiology, Vachira Phuket Hospital, Faculty of Medicine, Prince of Songkla University)
  • Received : 2023.09.10
  • Accepted : 2024.01.18
  • Published : 2024.05.01
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose To examine the technical considerations of endovascular treatment for aortoiliac occlusive disease (AIOD) based on a 10-year experience in Songklanagarind Hospital. Materials and Methods This retrospective cohort study included 210 patients who underwent endovascular treatment for symptomatic AIOD between January 2010 and December 2020. The patients' clinical and lesion characteristics, including technical considerations of the procedure, were collected, analyzed, and stratified using the Transatlantic Inter-Society Consensus (TASC). Results Most patients (80%) in this study had chronic limb-threatening ischemia lesions, with an occlusion rate of 37%. The technical success rate of TASC C & D was lower than that of TASC A & B, 84.4% vs. 99.2% p ≤ 0.001. A technical success rate of 93.3% (14/15) was found for the femoral and brachial approach, compared with a success rate of 89.0% (57/64) for the unibifemoral approach in TASC C & D, without a statistically significant difference (p = 0.076). However, the puncture site complications in this route were up to 17.6%, which is the highest rate compared with other techniques. These complications could be treated either conservatively or minimally invasively. Conclusion In cases of failed femoral access, simultaneous femoral and brachial approaches improved the technical success rate of endovascular recanalization of TASC C & D aortoiliac occlusions.

Keywords

References

  1. Bredahl K, Jensen LP, Schroeder TV, Sillesen H, Nielsen H, Eiberg JP. Mortality and complications after aortic bifurcated bypass procedures for chronic aortoiliac occlusive disease. J Vasc Surg 2015;62:75-82
  2. Reed AB, Conte MS, Donaldson MC, Mannick JA, Whittemore AD, Belkin M. The impact of patient age and aortic size on the results of aortobifemoral bypass grafting. J Vasc Surg 2003;37:1219-1225
  3. Sixt S, Alawied AK, Rastan A, Schwarzwalder 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;15:408-416
  4. Sixt S, Krankenberg H, Mohrle C, Kaspar M, Tubler T, Rastan A, et al. Endovascular treatment for extensive aortoiliac artery reconstruction: a single-center experience based on 1712 interventions. J Endovasc Ther 2013;20:64-73
  5. Della Schiava N, Naudin I, Bordet M, Arsicot M, Tresson P, Giai J, et al. Analysis of preoperative CT scan can help predict technical failure of endovascular treatment of TASC C-D aortoiliac chronic total occlusions. Ann Vasc Surg 2021;72:276-283
  6. Millon A, Della Schiava N, Brizzi V, Arsicot M, Boudjelit T, Herail J, et al. The antegrade approach using transbrachial access improves technical success rate of endovascular recanalization of TASC C-D aortoiliac occlusion in case of failed femoral access. Ann Vasc Surg 2015;29:1346-1352
  7. 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;53:1542-1549
  8. Jongkind V, Akkersdijk GJ, Yeung KK, Wisselink W. A systematic review of endovascular treatment of extensive aortoiliac occlusive disease. J Vasc Surg 2010;52:1376-1383
  9. 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;53:1728-1737
  10. Mwipatayi BP, Ouriel K, Anwari T, Wong J, Ducasse E, Panneton JM, et al. A systematic review of covered balloon-expandable stents for treating aortoiliac occlusive disease. J Vasc Surg 2020;72:1473-1486.e2
  11. 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;40:215-220
  12. Thawabi M, Tayal R, Hawatmeh A, Cohen M, Wasty N. Percutaneous transaxillary approach for peripheral endovascular interventions. Catheter Cardiovasc Interv 2019;94:243-248
  13. Moise MA, Alvarez-Tostado JA, Clair DG, Greenberg RK, Lyden SP, Srivastava SD, et al. Endovascular management of chronic infrarenal aortic occlusion. J Endovasc Ther 2009;16:84-92
  14. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG; TASC II Working Group. Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg 2007;45:S5-S67