Laganà D, Carrafiello G, Mangini M, Lumia D, Caronno R, Castelli P, Cuffari S, Fugazzola C
Vascular and Interventional Radiology, Department of Radiology, University of Insubria, Viale Borri 57, I-21100 Varese, Italy.
Radiol Med. 2006 Oct;111(7):949-58. doi: 10.1007/s11547-006-0093-5. Epub 2006 Oct 11.
Our aim is to report our experience in the endovascular treatment of steno-occlusions of the infrarenal abdominal aorta.
We selected 19 patients (mean age 66.3 years, range 45-80): five with complete occlusion of the infrarenal aorta and both common iliac arteries (CIAs), four of which were associated with occlusion of the external iliac arteries (EIAs); three with complete occlusion and three with severe stenosis of the distal aorta with occlusion or stenosis of the CIAs and EIAs; and eight with focal severe stenosis of the infrarenal aorta. All patients were treated with direct stenting.
Immediate technical success was 94.7% (18/19 cases). We observed two cases of distal embolism treated with thrombolysis, one case of mild renal failure and one case of transient angina abdominis. During the follow-up (mean 19.6 months; range 6-48), 2/18 (11.1%) occlusions of an iliac stent occurred 1 and 3 months after the procedure (treated with local intra-arterial thrombolysis). The primary patency rate was 88.8% and the secondary patency rate was 100%.
Direct stenting is a feasible and safe option for the treatment of infrarenal abdominal aortic steno-occlusions, especially in patients at high surgical risk, with good early and late clinical results.
我们旨在报告我们在肾下腹主动脉狭窄闭塞性病变血管内治疗方面的经验。
我们选择了19例患者（平均年龄66.3岁，范围45 - 80岁）：5例肾下腹主动脉及双侧髂总动脉（CIA）完全闭塞，其中4例合并髂外动脉（EIA）闭塞；3例肾下腹主动脉完全闭塞，3例肾下腹主动脉远端严重狭窄并伴有CIA和EIA闭塞或狭窄；8例肾下腹主动脉局灶性严重狭窄。所有患者均接受直接支架置入术。
即刻技术成功率为94.7%（18/19例）。我们观察到2例远端栓塞经溶栓治疗，1例轻度肾衰竭和1例短暂性腹部绞痛。在随访期间（平均19.6个月；范围6 - 48个月），18例中有2例（11.1%）髂动脉支架在术后1个月和3个月发生闭塞（经局部动脉内溶栓治疗）。一期通畅率为88.8%，二期通畅率为100%。
直接支架置入术是治疗肾下腹主动脉狭窄闭塞性病变的一种可行且安全的选择，尤其对于手术风险高的患者，具有良好的早期和晚期临床效果。
