Kato Taku, Zen Kan, Kawarada Osami, Hozawa Koji, Anzai Hitoshi, Nakamura Hiroaki, Funatsu Atsushi, Kawasaki Daizo, Tsubakimoto Yoshinori, Higashimori Akihiro, Kozuki Amane, Matoba Satoaki
Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan.
Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
AsiaIntervention. 2019 Jul;5(2):121-127. doi: 10.4244/AIJ-D-18-00050. Epub 2019 Jul 20.
The aim of this study was to evaluate the clinical outcomes of endovascular treatment (EVT) for chronic aortic occlusion (CAO) using multicentre registry data.
From April 2003 to December 2015, data on 73 consecutive patients (55 men and 18 women; aged 70.7±12.2 years) who underwent EVT for CAO were collected retrospectively from 15 centres in Japan. The primary endpoint was the primary patency at 12 months after EVT. Secondary endpoints were procedural success and periprocedural complication rates. We analysed 67 patients who underwent complete endovascular revascularisation after 2007. Initial procedural success was achieved in 63 cases (94.0%). Complications occurred in three patients (4.5%) (stroke, n=1; distal embolism, n=1; access-site haematoma requiring blood transfusion, n=1). In patients after successful EVT (n=63), the primary and secondary patency rates at 12 months were 90.7% and 97.7%, respectively. During a mean follow-up period of 17.8 months, restenosis/re-occlusion was observed in eight patients (12.7%).
EVT for CAO could be performed safely with a high procedural success rate. The short-term clinical outcome was acceptable despite lesion complexity.
本研究旨在利用多中心注册数据评估慢性主动脉闭塞(CAO)血管内治疗(EVT)的临床疗效。
从2003年4月至2015年12月,从日本15个中心回顾性收集73例连续接受CAO的EVT患者(55例男性和18例女性;年龄70.7±12.2岁)的数据。主要终点是EVT后12个月的主要通畅率。次要终点是手术成功率和围手术期并发症发生率。我们分析了2007年后接受完全血管内血运重建的67例患者。63例(94.0%)实现了初始手术成功。3例患者(4.5%)发生并发症(中风,n = 1;远端栓塞,n = 1;需要输血的穿刺部位血肿,n = 1)。在成功接受EVT的患者(n = 63)中,12个月时的主要和次要通畅率分别为90.7%和97.7%。在平均17.8个月的随访期内,8例患者(12.7%)观察到再狭窄/再闭塞。
CAO的EVT可以安全进行,手术成功率高。尽管病变复杂,但短期临床疗效是可以接受的。