Sevil Fehim Can, Tort Mehmet
Department of Cardiovascular Surgery, Erzurum Regional Education and Research Hospital, Erzurum, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Oct 21;28(4):601-608. doi: 10.5606/tgkdc.dergisi.2020.19668. eCollection 2020 Oct.
This study aims to investigate the effectiveness of endovascular applications for the treatment of spontaneous iliac artery dissections.
The medical records of 13 patients (12 males, 1 female; mean age 67.9±5.7 years; range, 58 to 75 years) with spontaneous iliac artery dissection between January 2017 and December 2019 were retrospectively reviewed. The diagnosis of spontaneous iliac artery dissection was made based on contrast-enhanced computed tomography. Demographic and clinical characteristics of the patients, physical examination and imaging findings, and hybrid treatments applied during endovascular treatment were analyzed.
The mean follow-up was 12.5±1.1 (range, 6 to 16) months. Five patients received hybrid treatment during endovascular treatment. The re-entry site was closed by a patch plasty over the common femoral artery in one of these patients. Embolectomy was performed in the remaining four patients for the treatment of acute ischemia of the extremities. Since no patency could be achieved in two of the patients undergoing embolectomy, a femoropopliteal bypass was performed. The technical success and primary patency rates were 100%. No new false lumen formation, intra-stent occlusion or arterial occlusion was observed during the hospital stay and follow-up.
Endovascular methods can be safely used in the treatment of spontaneous iliac artery dissections; however, hybrid treatments may be also required in selected cases. We believe that it is effective and safe to apply endovascular and hybrid treatments without preventing possible surgical treatments which may be required in the future.
本研究旨在探讨血管内介入治疗自发性髂动脉夹层的有效性。
回顾性分析2017年1月至2019年12月期间13例自发性髂动脉夹层患者（12例男性，1例女性；平均年龄67.9±5.7岁；范围58至75岁）的病历。自发性髂动脉夹层的诊断基于增强CT。分析患者的人口统计学和临床特征、体格检查和影像学表现以及血管内治疗期间应用的综合治疗方法。
平均随访时间为12.5±1.1（范围6至16）个月。5例患者在血管内治疗期间接受了综合治疗。其中1例患者通过在股总动脉上进行补片成形术封闭再入部位。其余4例患者因肢体急性缺血接受了取栓术。由于2例接受取栓术的患者未能实现血管通畅，因此进行了股腘动脉旁路移植术。技术成功率和一期通畅率均为100%。住院期间及随访期间未观察到新的假腔形成、支架内闭塞或动脉闭塞。
血管内方法可安全用于治疗自发性髂动脉夹层；然而，在某些特定情况下可能也需要综合治疗。我们认为，在不影响未来可能需要的手术治疗的情况下，应用血管内和综合治疗是有效且安全的。
