Outcomes of the Endovascular Treatment for the Supra-Aortic Trunks Occlusive Disease: A 14-Year Monocentric Experience

Autor: Eugenio Rosset, Juliette Hazart, Marie Benezit, Guillaume Daniel, Sabrina Ben Ahmed, Anthony Brouat
Rok vydání: 2015
Předmět:
Male
Percutaneous
Time Factors
Computed Tomography Angiography
medicine.medical_treatment
Myocardial Infarction
Subclavian Artery
Constriction
Pathologic
030204 cardiovascular system & hematology
0302 clinical medicine
Restenosis
Recurrence
Risk Factors
Medicine
Carotid Stenosis
Myocardial infarction
Brachiocephalic Trunk
Aged
80 and over
Hematoma
Endovascular Procedures
General Medicine
Middle Aged
Thrombosis
Treatment Outcome
Female
Radiology
France
Cardiology and Cardiovascular Medicine
Adult
medicine.medical_specialty
Arterial Occlusive Diseases
Punctures
03 medical and health sciences
Angioplasty
medicine.artery
Humans
Subclavian artery
Vascular Patency
Aged
Retrospective Studies
business.industry
Ultrasonography
Doppler
medicine.disease
Surgery
Stenosis
business
030217 neurology & neurosurgery
Zdroj: Annals of vascular surgery. 33
ISSN: 1615-5947
Popis: Background Endovascular treatment of proximal supra-aortic trunks (SAT) has become a safe and reliable alternative to conventional open surgery, with a lower morbimortality rate and good short- and middle-term patency rates. The aim of our study was to assess the long-term results of endovascular treatment of proximal lesions of the SAT (brachiocephalic trunk, common carotid artery, and subclavian artery) and identify predictive risk factors of restenosis. Methods From 1999 to 2013, 67 consecutive stenotic lesions of the proximal SAT were treated by angioplasty (13.4%) or stenting (86.6%) in 63 patients with a mean age of 65.5 years (40–87). Procedures were performed under general (69%), local (24%), or locoregional (7%) anesthesia, with percutaneous puncture (47.8%) or open access (52.2%). Patients were followed up for 3, 6, and 12 months, and then every year with clinical examination, Doppler ultrasound and if required an angio-CT scan. Results The technical success rate was 98.5%. There was no postoperative death or strokes. One myocardial infarction occurred at day 2. There were 2 access complications: a nonsurgical hematoma after brachial access and a brachial thrombosis postpuncture. The mean follow-up was 4.5 years (2–163 months). The primary- and assisted-patency rates were 90.1%, 86.4%, 77.9% and 93.3%, 91.4%, 82.9% at 1, 2, and 5 years, respectively. Eleven restenosis (16.4%) occurred at 28.5 months (3, 0–112, 0) of follow-up. Four of them required an endovascular repair and 3 required a surgical one. The restenosis rate was 17.5% in the stented group on average at 30.2 months of follow-up (range, 3.0–112.0) and 10% in the group of patients with angioplasty alone at 8 months of follow-up, without significant statistically difference (P = 0.9). No predictive risk factor of restenosis was statistically identified. Conclusions The endovascular treatment of proximal stenosis of SAT is a safe, reliable, and efficient technique with a low morbidity and mortality. The long-term results are good, but restenosis can occur. Long-term follow-up should be performed to detect and treat restenosis.
Databáze: OpenAIRE
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