Acute and Long-term Outcome of Endovascular Therapy for Aortoiliac Occlusive Lesions Stratified According to the TASC Classification:A Single-Center Experience
| Autor: | Aljoscha Rastan, Karlheinz Bürgelin, Michael Hauk, Kirsten Hauswald, Christian Müller, Ulrich Beschorner, Taher Nazary, Sebastian Sixt, Uwe Schwarzwälder, Franz-Josef Neumann, Abdul Karim Alawied, Thomas Schwarz, Ulrich Frank, Olli Leppänen, Martin Kleim, Elias Noory, Thomas Zeller |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Arterial Occlusive Diseases Single Center Iliac Artery Restenosis Recurrence Angioplasty medicine Humans Radiology Nuclear Medicine and imaging Aorta Abdominal Stage (cooking) Survival rate Vascular Patency Proportional Hazards Models Retrospective Studies Peripheral Vascular Diseases business.industry Stent Retrospective cohort study Middle Aged medicine.disease Surgery Survival Rate Treatment Outcome Cohort Female Stents Radiology Cardiology and Cardiovascular Medicine business Angioplasty Balloon |
| Zdroj: | Journal of Endovascular Therapy. 15:408-416 |
| ISSN: | 1545-1550 1526-6028 |
| DOI: | 10.1583/08-2359.1 |
| Popis: | PURPOSE: To compare acute and long-term outcomes of endovascular therapy for TASC (TransAtlantic Inter-Society Consensus) A and B lesions versus TASC C and D lesions. METHODS: Based on a prospectively maintained database, a retrospective analysis was conducted of 375 symptomatic patients (335 men; mean age 63+/-8 years) who underwent 438 interventions for aortoiliac arterial obstructions. Lesions were stratified according to the TASC II classification: 259 (59%) procedures involved TASC A/B lesions, while 113 (26%) were for TASC C and 66 (15%) for TASC D lesions. RESULTS: The baseline characteristics of patients with TASC A/B lesions differed significantly in the ankle-brachial index (ABI), occurrence of renal insufficiency, and lesion characteristics from those with TASC C or D lesions. Acute treatment success, defined as residual stenosis >30%, was 100%, 96%, 93%, and 100% for TASC A, B, C, and D lesions, respectively. The primary 1-year patency rate, which was 86% for the entire study cohort, was similar for all TASC classifications (89%, 86%, 86%, 85% for TASC A to D lesions, respectively). In the TASC A/B cohort, the 5-year event-free survival (70%) was not significantly better than in the C/D cohort (57%, p=0.124). The clinical outcome, as measured by Rutherford stage and ABI, improved significantly in all TASC subgroups after successful intervention and was maintained up to 1 year. Stenting was an independent predictor for lower restenosis rates (HR 0.517, 95% CI 0.317 to 0.842; p=0.008). CONCLUSION: In experienced hands, endovascular therapy of aortoiliac lesions can be successfully performed with sustained long-term outcome independent of the TASC II classification, even in class D lesions. |
| Databáze: | OpenAIRE |
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