Endovascular therapy for long-segment atherosclerotic aortoiliac occlusion.
OBJECTIVE
This retrospective nonrandomized study investigated the outcomes of endovascular therapy for long-segment atherosclerotic aortoiliac occlusion.


METHODS
From May 2008 to January 2013, 20 patients (one woman and 19 men; mean age, 66.1 years; range, 43-89 years) underwent stent implantation, with or without catheter-directed thrombolysis (CDT), for long-segment aortoiliac occlusion (>10 mm).


RESULTS
The technical success rate was 95% (19 of 20). No in-hospital mortality was recorded. Aortic thrombus was successfully eliminated with CDT in four patients before percutaneous transluminal angioplasty (PTA) and stenting. Retroperitoneal hemorrhage occurred in one patient, who refused further endovascular surgery. Another 15 patients were treated with PTA and stenting. Postoperative ankle-brachial indexes increased significantly from preoperative values (P < .05). Seventeen patients showed clinical improvement from baseline by an average of 2.5 Rutherford categories. The mean follow-up interval was 17.6 months (range, 4-39 months). The primary patency rates were 93.3% ± 6.4% at 6 months, 83% ± 11.3% at 18 months, and 66.4% ± 17.4% at 24 months.


CONCLUSIONS
Through brachial and femoral artery puncture, PTA, stenting, and CDT, endovascular therapy is feasible for complete long-segment infrarenal aortic occlusion, with lower complication rates and favorable midterm patency.
Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China.
Liangxi
L
Yuan
Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China. Electronic address: xueguankyb@163.com.
Junmin
J
Bao
Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China.
Zhiqing
Z
Zhao
Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China.
Xiang
X
Feng
Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China.
Qingsheng
Q
Lu
Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China. Electronic address: xueguankyy@163.com.
Zaiping
Z
Jing
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation; D055109:Ankle Brachial Index; D001018:Aortic Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D050197:Atherosclerosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D015912:Thrombolytic Therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency