Efficacy analysis of endovascular treatment for TASC-D type aortoiliac occlusive disease

LIN Fu-sen; LI Cheng-fu

doi:10.11958/20170029

Abstract：Objective To study the clinical effect of endovascular treatment on complex TASC-D type aortoiliac occlusive disease (AIOD). Methods Clinical data of 27 patients (35 limbs) of the TASC-D type AIOD were collected in Department of Cardiovascular Surgery and were retrospectively analyzed. According to the Fontaine staging and the corresponding imaging examination before surgery, the therapy programme was worked out. Two limbs received thrombectomies, and 33 limbs received endovascular treatments including 5 limbs received percutaneous transluminal angioplasty (PTA), 24 limbs received percutaneous transluminal angioplasty stenting (PTAS), and 4 limbs underwent catheter-directed thrombolysis. Patients were followed up for 3 to 36 months regularly by telephone or outpatient after operation. The clinical symptoms, ankle brachial index (ABI), complications and cumulative primary patency rates were evaluated. Results The overall success rate of endovascular treatment was 90.9% (30/33). Two limbs treated with PTAS and one limb with catheter-directed thormbolysis showed a poor outcome. ABI increased from (0.40 ± 0.15) prehospital to (0.82±0.20) for 1 month. After therapy for one year, the primary patency rate was 93.3%(28/30). At 24 months, the primary patency rate was 83.3%(25/30), and limb salvage rate was 94.3%(33/35). One limb resulted in above ankle amputation 10 days after admission to hospital, and 1 limb underwent toe amputation in 2 months after operation. Conclusion Endovascular therapy is a safe and effective method for TASC-D AIOD, which shows satisfactory clinical outcomes with short-term to mid-term patency rates.