Zan S, Varetto G, Maselli M, Conforti M, Moniaci D, Scovazzi P
Dipartimento di Discipline Medico-Chirurgiche, Cattedra e Scuola di Specializzazione in Chirurgia Vascolare, Azienda Ospedaliera S. Giovanni Battista, Torino, Università degli Studi di Torino, Turin, Italy.
Minerva Cardioangiol. 2003 Feb;51(1):71-7.
The different therapeutic approaches to unilateral occlusive iliac artery disease are analyzed.
In the period from September 1999 to September 2001, a total of 43 patients (38 males and 5 females) has been treated for unilateral iliac artery occlusive disease. Thirty-four cases (79%) underwent an endovascular procedure, and the remaining 9 cases (21%) had a surgical intervention. Endovascular techniques included 11 cases of percutaneous transluminal angioplasty (PTA) of common iliac artery (25.6% of whole series), 5 PTA of external iliac artery (11.6%), 8 PTA+stenting of common iliac artery (18.6%) and 10 PTA+stenting of external iliac artery (23.2%). In 9 cases a surgical revascularization was performed: 6 patients underwent a femoro-femoral cross-over bypass (14%); 2 cases were treated with aorto-bifemoral reconstruction (4.7%) and one patient was operated with ilio-femoral graft (2.3 %).
The analysis of the follow-up of our series showed, in the group of 34 patients treated with endovascular procedures, successful results were obtained in 79.4% (27 cases); in the 9 patients operated with surgical revascularization the success rate was 88.9% (8 cases ); failure rate was 20.6% for endovascular procedures and 11.1% for surgical interventions.
The conclusion is drawn that endovascular approach (PTA, stenting) is usually the procedure of choice in the treatment of unilateral well localised lesions of the iliac artery. Conventional surgical intervention is effective for revascularizing an extensive involvement of the iliac segment or in case of bilateral disease.
分析单侧闭塞性髂动脉疾病的不同治疗方法。
在1999年9月至2001年9月期间，共有43例患者（38例男性和5例女性）接受了单侧髂动脉闭塞性疾病的治疗。34例（79%）接受了血管内介入治疗，其余9例（21%）进行了外科手术干预。血管内技术包括11例髂总动脉经皮腔内血管成形术（PTA）（占整个系列的25.6%）、5例股外动脉PTA（11.6%）、8例髂总动脉PTA+支架置入术（18.6%）和10例股外动脉PTA+支架置入术（23.2%）。9例患者进行了外科血管重建：6例患者接受了股-股交叉搭桥术（14%）；2例接受了主动脉-双股动脉重建术（4.7%），1例患者接受了髂-股移植术（2.3%）。
对我们系列患者的随访分析显示，在接受血管内介入治疗的34例患者中，79.4%（27例）取得了成功结果；在接受外科血管重建的9例患者中，成功率为88.9%（8例）；血管内介入治疗的失败率为20.6%，外科手术干预的失败率为11.1%。
得出的结论是，血管内介入方法（PTA、支架置入）通常是治疗单侧局限性髂动脉病变的首选方法。传统外科手术干预对于髂动脉段广泛受累或双侧病变的血管重建是有效的。
