Acute and long-term outcome of endovascular therapy for aortoiliac occlusive lesions stratified according to the TASC classification: a single-center experience.
OBJECTIVE
To compare acute and long-term outcomes of endovascular therapy for TASC (TransAtlantic Inter-Society Consensus) A and B lesions versus TASC C and D lesions.


METHODS
Based on a prospectively maintained database, a retrospective analysis was conducted of 375 symptomatic patients (335 men; mean age 63+/-8 years) who underwent 438 interventions for aortoiliac arterial obstructions. Lesions were stratified according to the TASC II classification: 259 (59%) procedures involved TASC A/B lesions, while 113 (26%) were for TASC C and 66 (15%) for TASC D lesions.


RESULTS
The baseline characteristics of patients with TASC A/B lesions differed significantly in the ankle-brachial index (ABI), occurrence of renal insufficiency, and lesion characteristics from those with TASC C or D lesions. Acute treatment success, defined as residual stenosis <30%, was 100%, 96%, 93%, and 100% for TASC A, B, C, and D lesions, respectively. The primary 1-year patency rate, which was 86% for the entire study cohort, was similar for all TASC classifications (89%, 86%, 86%, 85% for TASC A to D lesions, respectively). In the TASC A/B cohort, the 5-year event-free survival (70%) was not significantly better than in the C/D cohort (57%, p=0.124). The clinical outcome, as measured by Rutherford stage and ABI, improved significantly in all TASC subgroups after successful intervention and was maintained up to 1 year. Stenting was an independent predictor for lower restenosis rates (HR 0.517, 95% CI 0.317 to 0.842; p=0.008).


CONCLUSIONS
In experienced hands, endovascular therapy of aortoiliac lesions can be successfully performed with sustained long-term outcome independent of the TASC II classification, even in class D lesions.
Sixt
Sebastian
S
Department of Angiology, Heart Centre Bad Krozingen, Germany. Sebastian.sixt@herzzentrum.de
Alawied
Abdul Karim
AK
Rastan
Aljoscha
A
Schwarzwälder
Uwe
U
Kleim
Martin
M
Noory
Elias
E
Schwarz
Thomas
T
Frank
Ulrich
U
Müller
Christian
C
Hauk
Michael
M
Beschorner
Ulrich
U
Nazary
Taher
T
Bürgelin
Karlheinz
K
Hauswald
Kirsten
K
Leppänen
Olli
O
Neumann
Franz-Josef
FJ
Zeller
Thomas
T
D000800:Angioplasty, Balloon; D001012:Aorta, Abdominal; D001157:Arterial Occlusive Diseases / Q000145:classification / Q000628:therapy*; D005260:Female; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000145:classification / Q000628:therapy*; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome; D014654:Vascular Patency