Andhyiswara T, Yo TI
Department of Surgery, St. Clara Hospital, Rotterdam, The Netherlands
Int J Angiol. 2000 Oct;9(4):232-235. doi: 10.1007/BF01623900.
To evaluate our experience of selective iliac artery stenting for total occlusions, a prospective observational study of 25 patients with an occluded iliac artery was designed to run from January 1996-May 1997. Exclusion criteria were an occlusion extended to the femoral artery, claudication Grade III or IV, according to the standards for reports dealing with lower extremity ischemia, and vascular (bypass) surgery in the past. Complete recanalization and selective stent placement was possible in all patients. No complications occurred. In one patient re-stenosis happened inside the stent after a year. Percutaneous reintervention was performed with success. The mean ankle-brachial pressure increased from 0.46 before the procedure to 0.95 after the procedure. After two years of follow-up, the mean ankle-brachial pressure is 0.93. The clinical stage improved by at least one grade to Grade 0 (Rutherford classification). The overall probability of patency for occluded iliac arteries in this study was 95% after two years. Recanalization, followed by percutaneous transluminal angioplasty (PTA) in the treatment of iliac artery occlusions, is our first choice of intervention, considering the absence of complication and satisfactory patency rates in patients with claudication Grade I or II.
为评估我们对髂动脉完全闭塞进行选择性髂动脉支架置入术的经验,我们设计了一项对25例髂动脉闭塞患者的前瞻性观察研究,研究时间为1996年1月至1997年5月。排除标准为闭塞延伸至股动脉、根据下肢缺血报告标准分级为III级或IV级的间歇性跛行以及既往有血管(搭桥)手术史。所有患者均成功实现完全再通并进行了选择性支架置入。未发生并发症。1例患者在术后1年支架内发生再狭窄。经皮再次干预成功。平均踝肱压从术前的0.46升至术后的0.95。经过两年随访,平均踝肱压为0.93。临床分期至少改善一级至0级(卢瑟福分类法)。本研究中髂动脉闭塞的两年通畅总体概率为95%。考虑到I级或II级间歇性跛行患者无并发症且通畅率令人满意,在髂动脉闭塞的治疗中,再通后行经皮腔内血管成形术(PTA)是我们的首选干预方法。