Department of Cardiology, University of Medical Sciences, Kartal Koşuyolu High Specialty Training and Research Hospital; İstanbul-Turkey.
Anatol J Cardiol. 2021 Apr;25(4):258-265. doi: 10.14744/AnatolJCardiol.2020.77550.
Endovascular therapy (EVT) has increasingly been used even after the development of new techniques and technologies. EVT has displayed durable early and mid-term outcomes for infrarenal aorta occlusions (IAO). Nonetheless, little is known regarding their long-term outcomes and predictors of restenosis.
A total of 55 consecutive patients (age, 58.8±6.97 years; 67.2% male; 42% critical limb ischemia) from a single-center database, undergoing EVT for IAO disease between January 2011 and March 2019 were retrospectively analyzed. The outcome measures were primary patency rate and amputation free survival calculated by the Kaplan-Meier method. Independent predictors of restenosis were assessed by Cox proportional hazard regression model.
In 49 patients (89.1%), technical success was achieved. In total, 190 stents (65 self-expandable stents, 60 balloon-expandable stents) were implanted. During the follow up of 34.5±28 months, 7 patients experienced loss of patency. Primary patency rates were 96%, 82%, and 75% at 1, 3, and 5 years, respectively, and amputation free survival rates were 100%, 90%, and 82% at 1, 3, and 5 years, respectively.
In this study, five-year outcomes of primary patency and amputation free survival for EVT of infrarenal aorta total occlusive lesions were favorable. None of the demographic, lesion, and device factors were independently associated with loss of primary patency.
即使在新技术和技术发展之后，血管内治疗（EVT）的应用也越来越多。EVT 显示出对肾下主动脉闭塞（IAO）的持久早期和中期结果。然而，对于其长期结果和再狭窄的预测因素知之甚少。
回顾性分析了 2011 年 1 月至 2019 年 3 月期间，来自单中心数据库的 55 例连续患者（年龄 58.8±6.97 岁；67.2%为男性；42%为严重肢体缺血）的资料，这些患者因 IAO 疾病接受 EVT 治疗。主要通畅率和免于截肢的生存率通过 Kaplan-Meier 方法计算。通过 Cox 比例风险回归模型评估再狭窄的独立预测因素。
在 49 例（89.1%）患者中，达到了技术上的成功。总共植入了 190 个支架（65 个自膨式支架，60 个球囊扩张式支架）。在 34.5±28 个月的随访中，7 例患者出现通畅丧失。1、3 和 5 年的主要通畅率分别为 96%、82%和 75%，免于截肢的生存率分别为 100%、90%和 82%。
在这项研究中，EVT 治疗肾下主动脉完全闭塞病变的 5 年主要通畅率和免于截肢的生存率是有利的。人口统计学、病变和设备因素均与主要通畅丧失无关。
