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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
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.