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A Journal on Vascular and Endovascular Surgery

Official Journal of the Italian Society of Vascular and Endovascular Surgery
Indexed/Abstracted in: EMBASE, Scopus




Giornale Italiano di Chirurgia Vascolare 1999 March;6(1):45-57

language: English, Italian

Endovascular treat­ment of ste­not­ic and obstruc­tive ­lesions of the aor­toi­liac seg­ment. Our ratio­nale ­after a ­review of 10 ­years’, expe­ri­ence

Bonelli U., Cerruti R., Baglietto F., Cantello C., Arnuzzo L., Patrone P.

From the Division of Vascular Surgery Hospital of S. Corona, Pietra Ligure, Savona, Italy


Background and aim. The ­authors ­report ­their expe­ri­ence in the treat­ment of ­steno-obstruc­tive ­lesions of the aor­toi­liac ­tract ­using angio­plas­ty ­with or with­out stent­ing. They eval­u­ate the indi­ca­tions and ­results ­that can be rea­son­ably expect­ed ­based on a fol­low-up of ­between 1 and 10 ­years.
Methods. A ­total of 229 ­patients ­were select­ed for endo­vas­cu­lar pro­ce­dures ­which ­were com­plet­ed in 205 ­patients: 95 PTA and 110 PTA + stent­ing. The 95 PTA ­were sub­di­vid­ed as fol­lows: 4 abdom­i­nal aor­ta, 46 com­mon ­iliac ­artery, 26 exter­nal prox­i­mal ­iliac ­artery, 16 exter­nal dis­tal ­iliac ­artery; the 110 PTA + stent­ing: 4 abdom­i­nal aor­ta, 43 com­mon ­iliac arter­ies, 33 exter­nal prox­i­mal ­iliac arter­ies, 30 dis­tal exter­nal ­iliac arter­ies. The ­mean ­length of ­steno-obstruc­tions was 2-4 cm.
A cor­rect fol­low-up was per­formed in 181 ­patients ­with clin­i­cal exam­ina­tion, ­colour Doppler ultra­so­nog­ra­phy and angio­graph­ic imag­ing in select­ed cas­es.
Results. The paten­cies ­obtained ­were cal­cu­lat­ed ­using the ­life ­table anal­y­sis meth­od ­that ­showed the fol­low­ing paten­cies dur­ing a var­i­able inter­val of 1 to 10 ­years: simple com­mon aor­toi­liac PTA 72.9%, prox­i­mal ­tract of the exter­nal ­iliac ­artery 46%, dis­tal exter­nal ­iliac ­artery 22.7%; PTA + stent­ing of the com­mon aor­toi­liac ­artery 87%, prox­i­mal exter­nal ­iliac ­artery 72%, dis­tal exter­nal ­iliac ­artery 51%. Only ­local com­pli­ca­tions ­occurred dur­ing pro­ce­dures due to the ­need for emer­gen­cy sur­gery in 13 (5.6%) cas­es ­with ­wide dis­sec­tions. No gen­er­al com­pli­ca­tions ­were ­observed. During the fol­low-up ­only 5 ­redo-PTA and 22 oper­a­tions ­were per­formed.
Conclusions. A com­par­i­son of the ­results ­with ­those report­ed by oth­er ­authors ­shows the effi­ca­cy of the endo­vas­cu­lar pro­ce­dure for the treat­ment of ­steno-obstruc­tive ­lesions of the aor­toi­liac ­tract. The pro­ce­dure is not ham­pered by gen­er­al com­pli­ca­tions for the ­patient and ­should there­fore be regard­ed as the ­first ­step in the man­age­ment of ­these ­lesions, ­even if in cas­es of re-sten­o­sis fol­low­ing pro­gres­sion of the dis­ease and inval­i­dat­ing symp­toms it may be pref­er­able to ­resort to sur­gery.

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