Chen Tai-Wei, Huang Chun-Yang, Chen Po-Lin, Lee Chiu-Yang, Shih Chun-Che, Chen I-Ming
Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital.
Department of Medicine.
Acta Cardiol Sin. 2018 Jul;34(4):313-320. doi: 10.6515/ACS.201807_34(4).20180301A.
Treatment for extensive aortoiliac occlusive disease (AIOD) includes endovascular interventions, hybrid procedures and surgical reconstruction. This study evaluated the short-term outcomes of endovascular and hybrid procedures in patients with Trans-Atlantic Inter-Society Consensus II (TASC-II) D AIOD lesions.
From January 2013 to June 2015, 41 patients with TASC-II D AIOD lesions who underwent revascularization at our institute were retrospectively included. Nineteen underwent endovascular procedures and 22 underwent hybrid procedures with a postoperative surveillance program for at least 1 year. Patient demographics and short-term outcomes were analyzed.
The procedural success rate in all patients was 100%. The accumulative postoperative complication rate was 20.2%, and the major complication was acute kidney injury (14.6%). The time of freedom from target lesion revascularization was 18.9 months. The primary patency rates in the endovascular group were 89.5% and 84.2% at 1 and 2 years, respectively, compared to 95.5% at 1 and 2 years in the hybrid group; however, the difference was not significant (p = 0.234). The secondary patency rates were 94.7% and 93% at 1 and 2 years, respectively, in the endovascular group, and 95.5% and 94% at 1 and 2 years, respectively, in the hybrid group; however, the differences was not significant (p = 0.916).
Our study revealed that endovascular and hybrid procedures are favorable treatment choices for patients with TASC-II D AIOD lesions. In patients with multilevel steno-occlusive lesions, hybrid procedures improved distal runoff flow and reduced the complexity of endovascular procedures.
广泛的主-髂动脉闭塞性疾病（AIOD）的治疗方法包括血管内介入治疗、杂交手术和外科重建。本研究评估了经皮腔内血管成形术（TASC-II）D型AIOD病变患者行血管内介入治疗和杂交手术的短期疗效。
回顾性纳入2013年1月至2015年6月在我院接受血运重建的41例TASC-II D型AIOD病变患者。19例行血管内介入治疗，22例行杂交手术，并进行至少1年的术后监测。分析患者的人口统计学特征和短期疗效。
所有患者的手术成功率为100%。术后累积并发症发生率为20.2%，主要并发症为急性肾损伤（14.6%）。无靶病变血运重建的时间为18.9个月。血管内介入治疗组1年和2年的原发性通畅率分别为89.5%和84.2%，杂交手术组1年和2年的原发性通畅率分别为95.5%；然而，差异无统计学意义（p = 0.234）。血管内介入治疗组1年和2年的继发性通畅率分别为94.7%和93%，杂交手术组1年和2年的继发性通畅率分别为95.5%和94%；然而，差异无统计学意义（p = 0.916）。
我们的研究表明，血管内介入治疗和杂交手术是TASC-II D型AIOD病变患者的良好治疗选择。对于多节段狭窄闭塞性病变患者，杂交手术改善了远端血流，并降低了血管内介入治疗的复杂性。
