Effect of endovascular treatment for aorto-iliac artery occlusive disease_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Chunmin , REN Hualiang , LENG Rui , WANG Qi ,  ZHANG Wangde

Department of Vascular Surgery, Beijing Chaoyang Hospital Affiliated to Capital Cedical University, Beijing 100020, P. R. China;

Corresponding author：

ZHANG Wangde, Email: drwangde@vip.sina.com

Keywords：

aorto-iliac artery occlusive disease; endovascular treatment; effect

DOI：

10.7507/1007-9424.201903081

Video：

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Objective To explore the technique experience and short- term and long-term effect of endovascular treatment on aorioiliac artery occlusive disease.Methods Clinical data of 131 patients were admitted for aorioiliac artery occlusive disease in the Department of Vascular Surgery of Beijing Chaoyang Hospital Affiliated to Capital Cedical University in recent years were analyzed.Results All the 131 patients underwent surgical operation, including 5 cases of pure catheterization (CDT); 94 cases of balloon dilatation and stent implantation; 23 cases which combind CDT, balloon dilatation, and stent implantation; 3 cases of pure balloon dilatation and 6 complicated cases of hybrid surgery. The mean operative time was 90 minutes, mean hospitaliztion time was 5 days. There were 6 cases occurred complications during perioperative period, including 3 cases of hematoma, 1 case of retroperitoneal hematoma, 1 case of acute transient ischemic attacks (TIA), and 1 case of pulmonary infection. There were 113 patients were followed-up for 1–32 months, and the median time was 16 months, the follow-up rate was 86.3% (113/131). During the follow-up period, 2 patients died, 1 died of myocardial infarction and 1 died of multi-organ failure. The one-year patency rate was 89.3% (100/112). During the follow-up period, 13 patients relapsed, including 5 patients who underwent secondary stent implantation, 1 patient who underwent CDT and percutaneous transluminal angioplasty (PTA), and 7 patients who received conservative treatment due to mild symptoms.Conclusions The treatment of aorioiliac artery occlusive disease still needs to choose reasonable measures according to the lesions, and even several measures should be combined to simplify the lesions, lower risk and receive better effect.

Citation： LI Chunmin, REN Hualiang, LENG Rui, WANG Qi, ZHANG Wangde. Effect of endovascular treatment for aorto-iliac artery occlusive disease. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(10): 1201-1204. doi: 10.7507/1007-9424.201903081 Copy

1.	Juergens JL, Barker NW, Hines EA Jr. Arteriosclerosis obliterans: review of 520 cases with special reference to pathogenic and prognostic factors. Circulation, 1960, 21: 188-195.
2.	Gabel JA, Kiang SC, Abou-Zamzam AM Jr, et al. Trans-atlantic inter-society consensus class d aortoiliac lesions: a comparison of endovascular and open surgical outcomes. AJR Am J Roentgenol, 2019, [Epub ahead of print].
3.	Jongkind V, Akkersdijk GJ, Yeung KK, et al. A systematic review of endovascular treatment of extensive aortoiliac occlusive disease. J Vasc Surg, 2010, 52(5): 1376-1383.
4.	Bekken JA, Jongsma H, Fioole B. The use of covered stents in aortoiliac obstructions: a systematic review and meta-analysis. J Cardiovasc Surg (Torino), 2018, 59(1): 14-25.
5.	Norgren L, Hiatt WR, Dormandy JA, et al. Inter-society consensus for the management of peripheral arterial disease (TASC Ⅱ). Eur J Vasc Endovasc Surg, 2007, 33(Suppl 1): S1-S75.
6.	Indes JE, Mandawat A, Tuggle CT, et al. Endovascular procedures for aorto-iliac occlusive disease are associated with superior short-term clinical and economic outcomes compared with open surgery in the inpatient population. J Vasc Surg, 2010, 52(5): 1173-1179.
7.	Dorigo W, Piffaretti G, Benedetto F, et al. A comparison between aortobifemoral bypass and aortoiliac kissing stents in patients with complex aortoiliac obstructive disease. J Vasc Surg, 2017, 65(1): 99-107.
8.	Revuelta Suero S, Martínez López I, Hernando Rydings M, et al. Endovascular treatment of external iliac artery occlusive disease: midterm results. J Endovasc Ther, 2014, 21(2): 223-229.
9.	Millon A, Della Schiava N, Brizzi V, et al. The Antegrade Approach Using Transbrachial Access Improves Technical Success Rate of Endovascular Recanalization of TASC C-D Aortoiliac Occlusion in Case of Failed Femoral Access. Ann Vasc Surg, 2015, 29(7): 1346-1352.
10.	Stavroulakis K, Usai MV, Torsello G, et al. Efficacy and Safety of Transbrachial Access for Iliac Endovascular Interventions. J Endovasc Ther, 2016, 23(3): 454-460.
11.	Gedikoglu M, Oguzkurt L, Gur S, et al. Comparison of ultrasound guidance with the traditional palpation and fluoroscopy method for the common femoral artery puncture. Catheter Cardiovasc Interv, 2013, 82(7): 1187-1192.
12.	Franz RW, Tanga CF, Herrmann JW. Treatment of peripheral arterial disease via percutaneous brachial artery access. J Vasc Surg, 2017, 66(2): 461-465.
13.	Varcoe RL. Re-entry device use in the endovascular treatment of aorto-iliac occlusive disease. J Cardiovasc Surg (Torino), 2012, 53(3): 313-323.
14.	Kawarada O, Noguchi T, Yasuda S. Longitudinal cracking with a guidewire tail for extremely calcified lesions in infrainguinal arteries: PICKING technique. Cardiovasc Intervent Radiol, 2018, 41(2): 313-316.
15.	Maniwa N, Kawarada O, Noguchi T, et al. Parallel wire technique with 40-g tip-load guidewire for severely calcified chronic total occlusion in the infrainguinal artery: heaviness makes the difference. JACC Cardiovasc Interv, 2016, 9(16): e159-e161.
16.	Grip O, Kuoppala M, Acosta S, et al. Outcome and complications after intra-arterial thrombolysis for lower limb ischaemia with or without continuous heparin infusion. Br J Surg, 2014, 101(9): 1105-1112.
17.	Golchehr B, Kruse R, van Walraven LA, et al. Three-year outcome of the heparin-bonded Viabahn for superficial femoral artery occlusive disease. J Vasc Surg, 2015, 62(4): 984-989.
18.	Feldman DN, Klein AJP. Stent selection in the iliac arteries: don’t fall through the ice. JACC Cardiovasc Interv, 2017, 10(16): 1705-1707.
19.	Laird JR, Zeller T, Holden A, et al. Balloon-expandable vascular covered stent in the treatment of iliac artery occlusive disease:9-month results from the BOLSTER Multicenter Study. J Vasc Interv Radiol, 2019, 30(6): 836-844.
20.	Dosluoglu HH, Lall P, Cherr GS, et al. Role of simple and complex hybrid revascularization procedures for symptomatic lower extremity occlusive disease. J Vasc Surg, 2010, 51(6): 1425-1435.
21.	Troisi N, Ercolini L, Peretti E, et al. Drug-eluting balloons to treat iliac in-stent restenosis. Ann Vasc Surg, 2015, 29(6): 1315. e3-e6.
22.	Subherwal S, Patel MR, Kober L, et al. Peripheral artery disease is a coronary heart disease risk equivalent among both men and women: results from a nationwide study. Eur J Prev Cardiol, 2015, 22(3): 317-325.
23.	Fähling M, Seeliger E, Patzak A, et al. Understanding and preventing contrast-induced acute kidney injury. Nat Rev Nephrol, 2017, 13(3): 169-180.
24.	Sajnani N, Bogart DB. Retroperitoneal hemorrhage as a complication of percutaneous intervention: report of 2 cases and review of the literature. Open Cardiovasc Med J, 2013, 7(1): 16-22.
25.	Neisen MJ. Endovascular management of aortoiliac occlusive disease. Semin Intervent Radiol, 2009, 26(4): 296-302.

1. Juergens JL, Barker NW, Hines EA Jr. Arteriosclerosis obliterans: review of 520 cases with special reference to pathogenic and prognostic factors. Circulation, 1960, 21: 188-195.
2. Gabel JA, Kiang SC, Abou-Zamzam AM Jr, et al. Trans-atlantic inter-society consensus class d aortoiliac lesions: a comparison of endovascular and open surgical outcomes. AJR Am J Roentgenol, 2019, [Epub ahead of print].
3. Jongkind V, Akkersdijk GJ, Yeung KK, et al. A systematic review of endovascular treatment of extensive aortoiliac occlusive disease. J Vasc Surg, 2010, 52(5): 1376-1383.
4. Bekken JA, Jongsma H, Fioole B. The use of covered stents in aortoiliac obstructions: a systematic review and meta-analysis. J Cardiovasc Surg (Torino), 2018, 59(1): 14-25.
5. Norgren L, Hiatt WR, Dormandy JA, et al. Inter-society consensus for the management of peripheral arterial disease (TASC Ⅱ). Eur J Vasc Endovasc Surg, 2007, 33(Suppl 1): S1-S75.
6. Indes JE, Mandawat A, Tuggle CT, et al. Endovascular procedures for aorto-iliac occlusive disease are associated with superior short-term clinical and economic outcomes compared with open surgery in the inpatient population. J Vasc Surg, 2010, 52(5): 1173-1179.
7. Dorigo W, Piffaretti G, Benedetto F, et al. A comparison between aortobifemoral bypass and aortoiliac kissing stents in patients with complex aortoiliac obstructive disease. J Vasc Surg, 2017, 65(1): 99-107.
8. Revuelta Suero S, Martínez López I, Hernando Rydings M, et al. Endovascular treatment of external iliac artery occlusive disease: midterm results. J Endovasc Ther, 2014, 21(2): 223-229.
9. Millon A, Della Schiava N, Brizzi V, et al. The Antegrade Approach Using Transbrachial Access Improves Technical Success Rate of Endovascular Recanalization of TASC C-D Aortoiliac Occlusion in Case of Failed Femoral Access. Ann Vasc Surg, 2015, 29(7): 1346-1352.
10. Stavroulakis K, Usai MV, Torsello G, et al. Efficacy and Safety of Transbrachial Access for Iliac Endovascular Interventions. J Endovasc Ther, 2016, 23(3): 454-460.
11. Gedikoglu M, Oguzkurt L, Gur S, et al. Comparison of ultrasound guidance with the traditional palpation and fluoroscopy method for the common femoral artery puncture. Catheter Cardiovasc Interv, 2013, 82(7): 1187-1192.
12. Franz RW, Tanga CF, Herrmann JW. Treatment of peripheral arterial disease via percutaneous brachial artery access. J Vasc Surg, 2017, 66(2): 461-465.
13. Varcoe RL. Re-entry device use in the endovascular treatment of aorto-iliac occlusive disease. J Cardiovasc Surg (Torino), 2012, 53(3): 313-323.
14. Kawarada O, Noguchi T, Yasuda S. Longitudinal cracking with a guidewire tail for extremely calcified lesions in infrainguinal arteries: PICKING technique. Cardiovasc Intervent Radiol, 2018, 41(2): 313-316.
15. Maniwa N, Kawarada O, Noguchi T, et al. Parallel wire technique with 40-g tip-load guidewire for severely calcified chronic total occlusion in the infrainguinal artery: heaviness makes the difference. JACC Cardiovasc Interv, 2016, 9(16): e159-e161.
16. Grip O, Kuoppala M, Acosta S, et al. Outcome and complications after intra-arterial thrombolysis for lower limb ischaemia with or without continuous heparin infusion. Br J Surg, 2014, 101(9): 1105-1112.
17. Golchehr B, Kruse R, van Walraven LA, et al. Three-year outcome of the heparin-bonded Viabahn for superficial femoral artery occlusive disease. J Vasc Surg, 2015, 62(4): 984-989.
18. Feldman DN, Klein AJP. Stent selection in the iliac arteries: don’t fall through the ice. JACC Cardiovasc Interv, 2017, 10(16): 1705-1707.
19. Laird JR, Zeller T, Holden A, et al. Balloon-expandable vascular covered stent in the treatment of iliac artery occlusive disease:9-month results from the BOLSTER Multicenter Study. J Vasc Interv Radiol, 2019, 30(6): 836-844.
20. Dosluoglu HH, Lall P, Cherr GS, et al. Role of simple and complex hybrid revascularization procedures for symptomatic lower extremity occlusive disease. J Vasc Surg, 2010, 51(6): 1425-1435.
21. Troisi N, Ercolini L, Peretti E, et al. Drug-eluting balloons to treat iliac in-stent restenosis. Ann Vasc Surg, 2015, 29(6): 1315. e3-e6.
22. Subherwal S, Patel MR, Kober L, et al. Peripheral artery disease is a coronary heart disease risk equivalent among both men and women: results from a nationwide study. Eur J Prev Cardiol, 2015, 22(3): 317-325.
23. Fähling M, Seeliger E, Patzak A, et al. Understanding and preventing contrast-induced acute kidney injury. Nat Rev Nephrol, 2017, 13(3): 169-180.
24. Sajnani N, Bogart DB. Retroperitoneal hemorrhage as a complication of percutaneous intervention: report of 2 cases and review of the literature. Open Cardiovasc Med J, 2013, 7(1): 16-22.
25. Neisen MJ. Endovascular management of aortoiliac occlusive disease. Semin Intervent Radiol, 2009, 26(4): 296-302.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of endovascular treatment for aorto-iliac artery occlusive disease

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