Journals / Türk Göğüs Kalp Damar Cerrahisi Dergisi / 2018 / Cilt: 26 - Sayı: 3

Percutaneous transluminal angioplasty/stent treatment of totally occlusive iliofemoral artery with limb ischemia: Experience of surgical team

Bacak iskemisi olan iliofemoral total oklüzyonlu hastalarda perkütan translüminal anjiyoplasti/stent tedavisi: Cerrahi Ekibin deneyimi

Pages
414–421
Publication Date
2022-09-02
DOI
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Five stent thrombosis patients (12.5%) were treated at different times.Conclusion: Our study results suggest that percutaneous transluminal angioplasty/stent treatment may be advisable in patients with significant comorbidities.

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Objective & Hypothesis:Background: In this study, we present our center’s experience on percutaneous transluminal angioplasty/stenting.Methods: Between January 2015 and March 2017, a total of 40 patients (34 males, 6 females; mean age 64.5±8.7 years; range, 49 to 85 years) who were treated in our clinic due to totally occluded iliofemoral artery disease were included.
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Key Findings & Data:There were 45 legs and 51 targeted vessels.
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Conclusion & Impact:Five stent thrombosis patients (12.5%) were treated at different times.Conclusion: Our study results suggest that percutaneous transluminal angioplasty/stent treatment may be advisable in patients with significant comorbidities.
🔬Design:Research Article
📍Scope:2015 Verileri
⚙️Variables:Domain Parameters

Abstract

Background: In this study, we present our center’s experience on percutaneous transluminal angioplasty/stenting.Methods: Between January 2015 and March 2017, a total of 40 patients (34 males, 6 females; mean age 64.5±8.7 years; range, 49 to 85 years) who were treated in our clinic due to totally occluded iliofemoral artery disease were included. There were 45 legs and 51 targeted vessels. Hybrid procedure was performed to those patients with iliofemoral or femoropopliteal bypass grafts.Results: A total of 48 target vessels (94.1%) were implanted using 55 stents at the initial attempt. Failed three target vessels (5.9%) were treated by surgical revascularization. There was no procedure-related mortality. Below-knee amputation was performed in one patient after 70 days. Two patients underwent single-finger amputation. Contrast nephropathy occurred in one patient and this patient was treated medically. The mean follow-up was 16.7±5 (range, 8 to 29) months. After follow-up, 41 stents were found to be patent without any intervention, and the primary patency rate was 74.5%. Five stent thrombosis patients (12.5%) were treated at different times.Conclusion: Our study results suggest that percutaneous transluminal angioplasty/stent treatment may be advisable in patients with significant comorbidities. The lower rates of complication in the stent series strongly suggest that, in experienced hands, percutaneous transluminal angioplasty/stent can offer lower procedural risks than surgical revascularization. Hybrid procedure is likely to be a reasonable choice for previously intervened comorbid patients for limb salvage.

Özet

Amaç: Bu çalışmada, merkezimizin perkütan translüminal anjiyoplasti/stentleme deneyimi sunuldu. Çalış­ma­ planı:­ Ocak 2015 - Mart 2017 tarihleri arasında iliofemoral total oklüzyon hastalığı nedeniyle kliniğimizde tedavi edilen toplam 40 hasta (34 erkek, 6 kadın; ort. yaş 64.5±8.7 yıl; dağılım, 49-85 yıl) çalışmaya alındı. Kırk beş bacak ve 51 hedef damar vardı. İliofemoral veya femoropopliteal baypas greftli olan bu hastalara hibrid işlem yapıldı. Bulgular: İlk girişimde 48 hedef damara (%94.1) 55 stent yerleştirildi. Başarısız üç hedef damar (%5.9), daha sonra cerrahi revaskülarizasyon ile tedavi edildi. İşleme bağlı mortalite görülmedi. Bir hastaya 70 gün sonra diz altı ampütasyon yapıldı. İki hastaya tek parmak ampütasyonu yapıldı. Bir hastada kontrast nefropati gelişti ve bu hasta tıbbi olarak tedavi edildi. Ortalama takip süresi 16.7±5 (dağılım, 8-29) ay idi. Takip sonrasında, 41 stent müdahale olmaksızın açık olarak tespit edildi ve primer açıklık oranı %74.5 idi. Beş stent trombozu hastası (%12.5) farklı zamanlarda tedavi edildi. Sonuç:­ Çalışma sonuçlarımız, ciddi komorbiditeli hastalara perkütan translüminal anjiyoplasti/stent tedavisinin önerilebileceğini göstermektedir. Stent serilerindeki nispeten düşük komplikasyon oranları, deneyimli ellerde perkütan translüminal anjiyoplasti/stentin, cerrahi revaskülarizasyona kıyasla, işleme bağlı riskinin daha düşük olduğuna işaret etmektedir. Hibrid işlem, daha önce girişimde bulunulan komorbiditeli hastalarda bacak kurtarma amacıyla uygun bir işlem olarak görülmektedir.

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Cite This Article

ATA, E. C., ŞENEL, M. (2022). Percutaneous transluminal angioplasty/stent treatment of totally occlusive iliofemoral artery with limb ischemia: Experience of surgical team. Türk Göğüs Kalp Damar Cerrahisi Dergisi, Cilt: 26 - Sayı: 3, 414–421. https://ajindex.com/articles/423869

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