Percutaneous Transluminal Revascularization for Iliac Occlusive Disease: Long-term Outcomes in TransAtlantic Inter-Society Consensus A and B Lesions
Abstract Percutaneous transluminal intervention for atherosclerotic iliac occlusive disease is now commonplace. We examine the long-term outcomes of TransAtlantic Inter-Society Consensus (TASC) A and B lesions. We performed a retrospective anonymous analysis of records from patients who underwent il...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Galaria, Irfan I. [verfasserIn] G. Davies, Mark [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2005 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Annals of vascular surgery - Orlando, Fla. : Elsevier, 1986, 19(2005), 3 vom: 07. Apr., Seite 352-360 |
|---|---|
| Übergeordnetes Werk: |
volume:19 ; year:2005 ; number:3 ; day:07 ; month:04 ; pages:352-360 |
| Links: |
|---|
| DOI / URN: |
10.1007/s10016-005-0010-8 |
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| 520 | |a Abstract Percutaneous transluminal intervention for atherosclerotic iliac occlusive disease is now commonplace. We examine the long-term outcomes of TransAtlantic Inter-Society Consensus (TASC) A and B lesions. We performed a retrospective anonymous analysis of records from patients who underwent iliac artery angioplasty with or without stenting between January 1990 and June 1999. Indications for intervention were symptomatic claudication (77%) or critical ischemia (23%). Altogether, 276 patients (all men; average age 64 ± 11 years range 32-87 years) underwent 394 interventions. Co-morbidities included hypertension (61%), hypercholesterolemia (45%), diabetes (28%), and chronic renal insufficiency (26%). A total of the 62% of the lesions were TASC category A, and the remainder were category B. Of the 394 primary interventions, 51% included placement of stents. Technical success (defined by < 30% residual stenosis) was achieved in 98% of treated vessels. The procedure-related mortality rate was 1.8% at 30 days and 4.7% at 90 days; the procedure-related complication rate was 7%. Hemodynamic success (defined as a rise in the ankle/branchial index > 0.15) was achieved in 82%. The average Society for Vascular Surgery symptom score was 3.4 ± 0.9 before intervention, which improved to 1.9 ± 0.8 following intervention. Within 3 months, 84% of patients demonstrated clinical improvement. Patient survival by life-table analysis was 38% at 10 years. The cumulative assisted patency rate was 71 ± 7% at 10 years. The presence of two-vessel femoral runoff, two or more patent tibial vessels, or both was associated with improved patency. Limb salvage was 95 ± 2% and 87 ± 9% at 5 and 10 years, respectively. Using Cox proportional hazards analysis, the presence of hypertension, hypercholesterolemia, or chronic renal insufficiency was associated with the occurrence of primary failure, whereas increased patency intervals were associated with the presence of immediate hemodynamic improvement. Use of a stent did not influence outcome. Endoluminal iliac intervention for TASC A and B lesions is a safe, durable intervention in patients with good femoral and tibial runoff. The presence of hypertension, hypercholesterolemia, or poor tibial runoff is associated with failure. | ||
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10.1007/s10016-005-0010-8 doi (DE-627)SPR008043523 (SPR)s10016-005-0010-8-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.65 bkl 44.85 bkl Galaria, Irfan I. verfasserin aut Percutaneous Transluminal Revascularization for Iliac Occlusive Disease: Long-term Outcomes in TransAtlantic Inter-Society Consensus A and B Lesions 2005 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Percutaneous transluminal intervention for atherosclerotic iliac occlusive disease is now commonplace. We examine the long-term outcomes of TransAtlantic Inter-Society Consensus (TASC) A and B lesions. We performed a retrospective anonymous analysis of records from patients who underwent iliac artery angioplasty with or without stenting between January 1990 and June 1999. Indications for intervention were symptomatic claudication (77%) or critical ischemia (23%). Altogether, 276 patients (all men; average age 64 ± 11 years range 32-87 years) underwent 394 interventions. Co-morbidities included hypertension (61%), hypercholesterolemia (45%), diabetes (28%), and chronic renal insufficiency (26%). A total of the 62% of the lesions were TASC category A, and the remainder were category B. Of the 394 primary interventions, 51% included placement of stents. Technical success (defined by < 30% residual stenosis) was achieved in 98% of treated vessels. The procedure-related mortality rate was 1.8% at 30 days and 4.7% at 90 days; the procedure-related complication rate was 7%. Hemodynamic success (defined as a rise in the ankle/branchial index > 0.15) was achieved in 82%. The average Society for Vascular Surgery symptom score was 3.4 ± 0.9 before intervention, which improved to 1.9 ± 0.8 following intervention. Within 3 months, 84% of patients demonstrated clinical improvement. Patient survival by life-table analysis was 38% at 10 years. The cumulative assisted patency rate was 71 ± 7% at 10 years. The presence of two-vessel femoral runoff, two or more patent tibial vessels, or both was associated with improved patency. Limb salvage was 95 ± 2% and 87 ± 9% at 5 and 10 years, respectively. Using Cox proportional hazards analysis, the presence of hypertension, hypercholesterolemia, or chronic renal insufficiency was associated with the occurrence of primary failure, whereas increased patency intervals were associated with the presence of immediate hemodynamic improvement. Use of a stent did not influence outcome. Endoluminal iliac intervention for TASC A and B lesions is a safe, durable intervention in patients with good femoral and tibial runoff. The presence of hypertension, hypercholesterolemia, or poor tibial runoff is associated with failure. Chronic Renal Insufficiency (dpeaa)DE-He213 Primary Patency (dpeaa)DE-He213 Secondary Patency (dpeaa)DE-He213 Secondary Patency Rate (dpeaa)DE-He213 Infrainguinal Bypass (dpeaa)DE-He213 G. Davies, Mark verfasserin aut Enthalten in Annals of vascular surgery Orlando, Fla. : Elsevier, 1986 19(2005), 3 vom: 07. Apr., Seite 352-360 (DE-627)269019731 (DE-600)1473891-0 1615-5947 nnns volume:19 year:2005 number:3 day:07 month:04 pages:352-360 https://dx.doi.org/10.1007/s10016-005-0010-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_40 GBV_ILN_74 GBV_ILN_267 GBV_ILN_702 GBV_ILN_2005 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4305 GBV_ILN_4307 GBV_ILN_4323 GBV_ILN_4333 GBV_ILN_4338 44.65 ASE 44.85 ASE AR 19 2005 3 07 04 352-360 |
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10.1007/s10016-005-0010-8 doi (DE-627)SPR008043523 (SPR)s10016-005-0010-8-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.65 bkl 44.85 bkl Galaria, Irfan I. verfasserin aut Percutaneous Transluminal Revascularization for Iliac Occlusive Disease: Long-term Outcomes in TransAtlantic Inter-Society Consensus A and B Lesions 2005 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Percutaneous transluminal intervention for atherosclerotic iliac occlusive disease is now commonplace. We examine the long-term outcomes of TransAtlantic Inter-Society Consensus (TASC) A and B lesions. We performed a retrospective anonymous analysis of records from patients who underwent iliac artery angioplasty with or without stenting between January 1990 and June 1999. Indications for intervention were symptomatic claudication (77%) or critical ischemia (23%). Altogether, 276 patients (all men; average age 64 ± 11 years range 32-87 years) underwent 394 interventions. Co-morbidities included hypertension (61%), hypercholesterolemia (45%), diabetes (28%), and chronic renal insufficiency (26%). A total of the 62% of the lesions were TASC category A, and the remainder were category B. Of the 394 primary interventions, 51% included placement of stents. Technical success (defined by < 30% residual stenosis) was achieved in 98% of treated vessels. The procedure-related mortality rate was 1.8% at 30 days and 4.7% at 90 days; the procedure-related complication rate was 7%. Hemodynamic success (defined as a rise in the ankle/branchial index > 0.15) was achieved in 82%. The average Society for Vascular Surgery symptom score was 3.4 ± 0.9 before intervention, which improved to 1.9 ± 0.8 following intervention. Within 3 months, 84% of patients demonstrated clinical improvement. Patient survival by life-table analysis was 38% at 10 years. The cumulative assisted patency rate was 71 ± 7% at 10 years. The presence of two-vessel femoral runoff, two or more patent tibial vessels, or both was associated with improved patency. Limb salvage was 95 ± 2% and 87 ± 9% at 5 and 10 years, respectively. Using Cox proportional hazards analysis, the presence of hypertension, hypercholesterolemia, or chronic renal insufficiency was associated with the occurrence of primary failure, whereas increased patency intervals were associated with the presence of immediate hemodynamic improvement. Use of a stent did not influence outcome. Endoluminal iliac intervention for TASC A and B lesions is a safe, durable intervention in patients with good femoral and tibial runoff. The presence of hypertension, hypercholesterolemia, or poor tibial runoff is associated with failure. Chronic Renal Insufficiency (dpeaa)DE-He213 Primary Patency (dpeaa)DE-He213 Secondary Patency (dpeaa)DE-He213 Secondary Patency Rate (dpeaa)DE-He213 Infrainguinal Bypass (dpeaa)DE-He213 G. Davies, Mark verfasserin aut Enthalten in Annals of vascular surgery Orlando, Fla. : Elsevier, 1986 19(2005), 3 vom: 07. Apr., Seite 352-360 (DE-627)269019731 (DE-600)1473891-0 1615-5947 nnns volume:19 year:2005 number:3 day:07 month:04 pages:352-360 https://dx.doi.org/10.1007/s10016-005-0010-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_40 GBV_ILN_74 GBV_ILN_267 GBV_ILN_702 GBV_ILN_2005 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4305 GBV_ILN_4307 GBV_ILN_4323 GBV_ILN_4333 GBV_ILN_4338 44.65 ASE 44.85 ASE AR 19 2005 3 07 04 352-360 |
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10.1007/s10016-005-0010-8 doi (DE-627)SPR008043523 (SPR)s10016-005-0010-8-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.65 bkl 44.85 bkl Galaria, Irfan I. verfasserin aut Percutaneous Transluminal Revascularization for Iliac Occlusive Disease: Long-term Outcomes in TransAtlantic Inter-Society Consensus A and B Lesions 2005 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Percutaneous transluminal intervention for atherosclerotic iliac occlusive disease is now commonplace. We examine the long-term outcomes of TransAtlantic Inter-Society Consensus (TASC) A and B lesions. We performed a retrospective anonymous analysis of records from patients who underwent iliac artery angioplasty with or without stenting between January 1990 and June 1999. Indications for intervention were symptomatic claudication (77%) or critical ischemia (23%). Altogether, 276 patients (all men; average age 64 ± 11 years range 32-87 years) underwent 394 interventions. Co-morbidities included hypertension (61%), hypercholesterolemia (45%), diabetes (28%), and chronic renal insufficiency (26%). A total of the 62% of the lesions were TASC category A, and the remainder were category B. Of the 394 primary interventions, 51% included placement of stents. Technical success (defined by < 30% residual stenosis) was achieved in 98% of treated vessels. The procedure-related mortality rate was 1.8% at 30 days and 4.7% at 90 days; the procedure-related complication rate was 7%. Hemodynamic success (defined as a rise in the ankle/branchial index > 0.15) was achieved in 82%. The average Society for Vascular Surgery symptom score was 3.4 ± 0.9 before intervention, which improved to 1.9 ± 0.8 following intervention. Within 3 months, 84% of patients demonstrated clinical improvement. Patient survival by life-table analysis was 38% at 10 years. The cumulative assisted patency rate was 71 ± 7% at 10 years. The presence of two-vessel femoral runoff, two or more patent tibial vessels, or both was associated with improved patency. Limb salvage was 95 ± 2% and 87 ± 9% at 5 and 10 years, respectively. Using Cox proportional hazards analysis, the presence of hypertension, hypercholesterolemia, or chronic renal insufficiency was associated with the occurrence of primary failure, whereas increased patency intervals were associated with the presence of immediate hemodynamic improvement. Use of a stent did not influence outcome. Endoluminal iliac intervention for TASC A and B lesions is a safe, durable intervention in patients with good femoral and tibial runoff. The presence of hypertension, hypercholesterolemia, or poor tibial runoff is associated with failure. Chronic Renal Insufficiency (dpeaa)DE-He213 Primary Patency (dpeaa)DE-He213 Secondary Patency (dpeaa)DE-He213 Secondary Patency Rate (dpeaa)DE-He213 Infrainguinal Bypass (dpeaa)DE-He213 G. Davies, Mark verfasserin aut Enthalten in Annals of vascular surgery Orlando, Fla. : Elsevier, 1986 19(2005), 3 vom: 07. Apr., Seite 352-360 (DE-627)269019731 (DE-600)1473891-0 1615-5947 nnns volume:19 year:2005 number:3 day:07 month:04 pages:352-360 https://dx.doi.org/10.1007/s10016-005-0010-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_40 GBV_ILN_74 GBV_ILN_267 GBV_ILN_702 GBV_ILN_2005 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4305 GBV_ILN_4307 GBV_ILN_4323 GBV_ILN_4333 GBV_ILN_4338 44.65 ASE 44.85 ASE AR 19 2005 3 07 04 352-360 |
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10.1007/s10016-005-0010-8 doi (DE-627)SPR008043523 (SPR)s10016-005-0010-8-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.65 bkl 44.85 bkl Galaria, Irfan I. verfasserin aut Percutaneous Transluminal Revascularization for Iliac Occlusive Disease: Long-term Outcomes in TransAtlantic Inter-Society Consensus A and B Lesions 2005 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Percutaneous transluminal intervention for atherosclerotic iliac occlusive disease is now commonplace. We examine the long-term outcomes of TransAtlantic Inter-Society Consensus (TASC) A and B lesions. We performed a retrospective anonymous analysis of records from patients who underwent iliac artery angioplasty with or without stenting between January 1990 and June 1999. Indications for intervention were symptomatic claudication (77%) or critical ischemia (23%). Altogether, 276 patients (all men; average age 64 ± 11 years range 32-87 years) underwent 394 interventions. Co-morbidities included hypertension (61%), hypercholesterolemia (45%), diabetes (28%), and chronic renal insufficiency (26%). A total of the 62% of the lesions were TASC category A, and the remainder were category B. Of the 394 primary interventions, 51% included placement of stents. Technical success (defined by < 30% residual stenosis) was achieved in 98% of treated vessels. The procedure-related mortality rate was 1.8% at 30 days and 4.7% at 90 days; the procedure-related complication rate was 7%. Hemodynamic success (defined as a rise in the ankle/branchial index > 0.15) was achieved in 82%. The average Society for Vascular Surgery symptom score was 3.4 ± 0.9 before intervention, which improved to 1.9 ± 0.8 following intervention. Within 3 months, 84% of patients demonstrated clinical improvement. Patient survival by life-table analysis was 38% at 10 years. The cumulative assisted patency rate was 71 ± 7% at 10 years. The presence of two-vessel femoral runoff, two or more patent tibial vessels, or both was associated with improved patency. Limb salvage was 95 ± 2% and 87 ± 9% at 5 and 10 years, respectively. Using Cox proportional hazards analysis, the presence of hypertension, hypercholesterolemia, or chronic renal insufficiency was associated with the occurrence of primary failure, whereas increased patency intervals were associated with the presence of immediate hemodynamic improvement. Use of a stent did not influence outcome. Endoluminal iliac intervention for TASC A and B lesions is a safe, durable intervention in patients with good femoral and tibial runoff. The presence of hypertension, hypercholesterolemia, or poor tibial runoff is associated with failure. Chronic Renal Insufficiency (dpeaa)DE-He213 Primary Patency (dpeaa)DE-He213 Secondary Patency (dpeaa)DE-He213 Secondary Patency Rate (dpeaa)DE-He213 Infrainguinal Bypass (dpeaa)DE-He213 G. Davies, Mark verfasserin aut Enthalten in Annals of vascular surgery Orlando, Fla. : Elsevier, 1986 19(2005), 3 vom: 07. Apr., Seite 352-360 (DE-627)269019731 (DE-600)1473891-0 1615-5947 nnns volume:19 year:2005 number:3 day:07 month:04 pages:352-360 https://dx.doi.org/10.1007/s10016-005-0010-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_40 GBV_ILN_74 GBV_ILN_267 GBV_ILN_702 GBV_ILN_2005 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4305 GBV_ILN_4307 GBV_ILN_4323 GBV_ILN_4333 GBV_ILN_4338 44.65 ASE 44.85 ASE AR 19 2005 3 07 04 352-360 |
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10.1007/s10016-005-0010-8 doi (DE-627)SPR008043523 (SPR)s10016-005-0010-8-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE 44.65 bkl 44.85 bkl Galaria, Irfan I. verfasserin aut Percutaneous Transluminal Revascularization for Iliac Occlusive Disease: Long-term Outcomes in TransAtlantic Inter-Society Consensus A and B Lesions 2005 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Percutaneous transluminal intervention for atherosclerotic iliac occlusive disease is now commonplace. We examine the long-term outcomes of TransAtlantic Inter-Society Consensus (TASC) A and B lesions. We performed a retrospective anonymous analysis of records from patients who underwent iliac artery angioplasty with or without stenting between January 1990 and June 1999. Indications for intervention were symptomatic claudication (77%) or critical ischemia (23%). Altogether, 276 patients (all men; average age 64 ± 11 years range 32-87 years) underwent 394 interventions. Co-morbidities included hypertension (61%), hypercholesterolemia (45%), diabetes (28%), and chronic renal insufficiency (26%). A total of the 62% of the lesions were TASC category A, and the remainder were category B. Of the 394 primary interventions, 51% included placement of stents. Technical success (defined by < 30% residual stenosis) was achieved in 98% of treated vessels. The procedure-related mortality rate was 1.8% at 30 days and 4.7% at 90 days; the procedure-related complication rate was 7%. Hemodynamic success (defined as a rise in the ankle/branchial index > 0.15) was achieved in 82%. The average Society for Vascular Surgery symptom score was 3.4 ± 0.9 before intervention, which improved to 1.9 ± 0.8 following intervention. Within 3 months, 84% of patients demonstrated clinical improvement. Patient survival by life-table analysis was 38% at 10 years. The cumulative assisted patency rate was 71 ± 7% at 10 years. The presence of two-vessel femoral runoff, two or more patent tibial vessels, or both was associated with improved patency. Limb salvage was 95 ± 2% and 87 ± 9% at 5 and 10 years, respectively. Using Cox proportional hazards analysis, the presence of hypertension, hypercholesterolemia, or chronic renal insufficiency was associated with the occurrence of primary failure, whereas increased patency intervals were associated with the presence of immediate hemodynamic improvement. Use of a stent did not influence outcome. Endoluminal iliac intervention for TASC A and B lesions is a safe, durable intervention in patients with good femoral and tibial runoff. The presence of hypertension, hypercholesterolemia, or poor tibial runoff is associated with failure. Chronic Renal Insufficiency (dpeaa)DE-He213 Primary Patency (dpeaa)DE-He213 Secondary Patency (dpeaa)DE-He213 Secondary Patency Rate (dpeaa)DE-He213 Infrainguinal Bypass (dpeaa)DE-He213 G. Davies, Mark verfasserin aut Enthalten in Annals of vascular surgery Orlando, Fla. : Elsevier, 1986 19(2005), 3 vom: 07. Apr., Seite 352-360 (DE-627)269019731 (DE-600)1473891-0 1615-5947 nnns volume:19 year:2005 number:3 day:07 month:04 pages:352-360 https://dx.doi.org/10.1007/s10016-005-0010-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_40 GBV_ILN_74 GBV_ILN_267 GBV_ILN_702 GBV_ILN_2005 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4305 GBV_ILN_4307 GBV_ILN_4323 GBV_ILN_4333 GBV_ILN_4338 44.65 ASE 44.85 ASE AR 19 2005 3 07 04 352-360 |
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Percutaneous Transluminal Revascularization for Iliac Occlusive Disease: Long-term Outcomes in TransAtlantic Inter-Society Consensus A and B Lesions |
| abstract |
Abstract Percutaneous transluminal intervention for atherosclerotic iliac occlusive disease is now commonplace. We examine the long-term outcomes of TransAtlantic Inter-Society Consensus (TASC) A and B lesions. We performed a retrospective anonymous analysis of records from patients who underwent iliac artery angioplasty with or without stenting between January 1990 and June 1999. Indications for intervention were symptomatic claudication (77%) or critical ischemia (23%). Altogether, 276 patients (all men; average age 64 ± 11 years range 32-87 years) underwent 394 interventions. Co-morbidities included hypertension (61%), hypercholesterolemia (45%), diabetes (28%), and chronic renal insufficiency (26%). A total of the 62% of the lesions were TASC category A, and the remainder were category B. Of the 394 primary interventions, 51% included placement of stents. Technical success (defined by < 30% residual stenosis) was achieved in 98% of treated vessels. The procedure-related mortality rate was 1.8% at 30 days and 4.7% at 90 days; the procedure-related complication rate was 7%. Hemodynamic success (defined as a rise in the ankle/branchial index > 0.15) was achieved in 82%. The average Society for Vascular Surgery symptom score was 3.4 ± 0.9 before intervention, which improved to 1.9 ± 0.8 following intervention. Within 3 months, 84% of patients demonstrated clinical improvement. Patient survival by life-table analysis was 38% at 10 years. The cumulative assisted patency rate was 71 ± 7% at 10 years. The presence of two-vessel femoral runoff, two or more patent tibial vessels, or both was associated with improved patency. Limb salvage was 95 ± 2% and 87 ± 9% at 5 and 10 years, respectively. Using Cox proportional hazards analysis, the presence of hypertension, hypercholesterolemia, or chronic renal insufficiency was associated with the occurrence of primary failure, whereas increased patency intervals were associated with the presence of immediate hemodynamic improvement. Use of a stent did not influence outcome. Endoluminal iliac intervention for TASC A and B lesions is a safe, durable intervention in patients with good femoral and tibial runoff. The presence of hypertension, hypercholesterolemia, or poor tibial runoff is associated with failure. |
| abstractGer |
Abstract Percutaneous transluminal intervention for atherosclerotic iliac occlusive disease is now commonplace. We examine the long-term outcomes of TransAtlantic Inter-Society Consensus (TASC) A and B lesions. We performed a retrospective anonymous analysis of records from patients who underwent iliac artery angioplasty with or without stenting between January 1990 and June 1999. Indications for intervention were symptomatic claudication (77%) or critical ischemia (23%). Altogether, 276 patients (all men; average age 64 ± 11 years range 32-87 years) underwent 394 interventions. Co-morbidities included hypertension (61%), hypercholesterolemia (45%), diabetes (28%), and chronic renal insufficiency (26%). A total of the 62% of the lesions were TASC category A, and the remainder were category B. Of the 394 primary interventions, 51% included placement of stents. Technical success (defined by < 30% residual stenosis) was achieved in 98% of treated vessels. The procedure-related mortality rate was 1.8% at 30 days and 4.7% at 90 days; the procedure-related complication rate was 7%. Hemodynamic success (defined as a rise in the ankle/branchial index > 0.15) was achieved in 82%. The average Society for Vascular Surgery symptom score was 3.4 ± 0.9 before intervention, which improved to 1.9 ± 0.8 following intervention. Within 3 months, 84% of patients demonstrated clinical improvement. Patient survival by life-table analysis was 38% at 10 years. The cumulative assisted patency rate was 71 ± 7% at 10 years. The presence of two-vessel femoral runoff, two or more patent tibial vessels, or both was associated with improved patency. Limb salvage was 95 ± 2% and 87 ± 9% at 5 and 10 years, respectively. Using Cox proportional hazards analysis, the presence of hypertension, hypercholesterolemia, or chronic renal insufficiency was associated with the occurrence of primary failure, whereas increased patency intervals were associated with the presence of immediate hemodynamic improvement. Use of a stent did not influence outcome. Endoluminal iliac intervention for TASC A and B lesions is a safe, durable intervention in patients with good femoral and tibial runoff. The presence of hypertension, hypercholesterolemia, or poor tibial runoff is associated with failure. |
| abstract_unstemmed |
Abstract Percutaneous transluminal intervention for atherosclerotic iliac occlusive disease is now commonplace. We examine the long-term outcomes of TransAtlantic Inter-Society Consensus (TASC) A and B lesions. We performed a retrospective anonymous analysis of records from patients who underwent iliac artery angioplasty with or without stenting between January 1990 and June 1999. Indications for intervention were symptomatic claudication (77%) or critical ischemia (23%). Altogether, 276 patients (all men; average age 64 ± 11 years range 32-87 years) underwent 394 interventions. Co-morbidities included hypertension (61%), hypercholesterolemia (45%), diabetes (28%), and chronic renal insufficiency (26%). A total of the 62% of the lesions were TASC category A, and the remainder were category B. Of the 394 primary interventions, 51% included placement of stents. Technical success (defined by < 30% residual stenosis) was achieved in 98% of treated vessels. The procedure-related mortality rate was 1.8% at 30 days and 4.7% at 90 days; the procedure-related complication rate was 7%. Hemodynamic success (defined as a rise in the ankle/branchial index > 0.15) was achieved in 82%. The average Society for Vascular Surgery symptom score was 3.4 ± 0.9 before intervention, which improved to 1.9 ± 0.8 following intervention. Within 3 months, 84% of patients demonstrated clinical improvement. Patient survival by life-table analysis was 38% at 10 years. The cumulative assisted patency rate was 71 ± 7% at 10 years. The presence of two-vessel femoral runoff, two or more patent tibial vessels, or both was associated with improved patency. Limb salvage was 95 ± 2% and 87 ± 9% at 5 and 10 years, respectively. Using Cox proportional hazards analysis, the presence of hypertension, hypercholesterolemia, or chronic renal insufficiency was associated with the occurrence of primary failure, whereas increased patency intervals were associated with the presence of immediate hemodynamic improvement. Use of a stent did not influence outcome. Endoluminal iliac intervention for TASC A and B lesions is a safe, durable intervention in patients with good femoral and tibial runoff. The presence of hypertension, hypercholesterolemia, or poor tibial runoff is associated with failure. |
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