Does conversion of intended remote iliac artery endarterectomy alter the early and long-term outcome?
The purpose of this study was to compare the perioperative and long-term results of initial successful remote iliac artery endarterectomies (RIAEs) with converted procedures. From April 1994 to September 2003, 63 remote endarterectomies of the external and/or common iliac artery were planned in 62 patients (41 males, 42 procedures). The median age was 65 years (range 39-83 years), and the indication for operation was severe claudication in 37 (59%), rest pain in 16 (25%), and gangrene in 10 (16%) procedures. Initial technical success was achieved in 56 (89%) procedures (group 1); seven conversions (group 2) were necessary. In group 1, the 5-year primary patency rate improved from 64 +/- 15% to a primary assisted patency of 88 +/- 9.3% after percutaneous transluminal angioplasty in 11 patients, with 7 requiring stent placement. The 5-year secondary patency rate was 94 +/- 7.4%. The primary and secondary patency rates in group 2 were 86 +/- 19% and 100%, respectively. RIAE can be offered to patients with long occlusions of the iliac arteries as a first treatment option. The inherent risk of a possible conversion of an intended RIAE to a more invasive surgical procedure has no significant adverse clinical effect on the early and 5-year clinical outcomes.
Smeets
Luuk
L
Department of Surgery, Twenteborg Hospital, Almelo, the Netherlands. smeets_luuk@hotmail.com
van der Horn
Garmt
G
Gisbertz
Suzanne S
SS
Ho
Gwan
G
Moll
Frans
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D004691:Endarterectomy / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D005734:Gangrene / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D007383:Intermittent Claudication / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010146:Pain / Q000601:surgery; D011183:Postoperative Complications; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome