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Endovascular Treatment of Total Occlusion of Aorta
: Long Term Follow up for Clinical Outcomes
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연세대학교 의과대학 심장혈관병원 심장내과 |
김현수, 문재연, 강태수, 고영국, 최동훈, 장양수, 정남식, 심원흠 |
Backgrounds: Endovascular treatment deploying a kissing stents technique has been used as an alternative to surgical intervention in treating symptomatic chronic aorta total occlusive disease. However, the long-term clinical outcomes are unknown. We retrospectively analyzed data on patients who underwent endovascular treatment on total occlusion of aorta.
Methods: A retrospective review of 27 patients aged 65.7±12.5 years with total infrarenal aorta occlusion underwent angioplasty using the kissing stents technique. The mean clinical follow up duration was 44.2±35.7 months.
Results: The initial manifestation of patients was mainly lifestyle-limiting claudication(62%). 9 diabetic patients and 1 Takayasu’s arteritis patient and 1 Buerger’s disease patient were enrolled. Immediate post-procedural outcomes were successful in all patients, although there was a 33% acute complication rate (distal embolization) which were treated with infusion of thrombolytics (Urokinase 200,000IU). Follow up was performed clinically, angiographically and CT angiography. 81 percent remained free of lifestyle-limiting claudication. 4 patients had complained claudication and repeated intervention at below the common iliac artery without target lesion revascularization and 1 patient receive bypass surgery. There was no death and amputation during follow up periods.
Conclusion: Endovascular treatment using the kissing stents technique is safe and effective for treatment of total aortic occlusive lesion. According to the excellent technical and follow-up results, this technique may be considered as a first-line treatment of symptomatic aortic total occlusive lesion. However, further investigation should be focused on long-term patency rates in comparison with surgical treatment.
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