Use of the loop endarterectomy from iliac arteries, supplemented with stenting, as a stage of hybrid operations in atherosclerotic multilevel lesions of aorto-iliac and femoral-popliteal segments

DOI: https://doi.org/10.25512/DIR.2012.06.1.06

For quoting:
Troitskij A.V., Khabazov R.I., Bekhterev A.G., Lysenko E.R. "Use of the loop endarterectomy from iliac arteries, supplemented with stenting, as a stage of hybrid operations in atherosclerotic multilevel lesions of aorto-iliac and femoral-popliteal segments". Journal Diagnostic & interventional radiology. 2012; 6(1); 39-48.

authors:

Troitskij A.V.

Khabazov R.I.

Bekhterev A.G.

Lysenko E.R.

keywords:

loop endarterectomy

hybrid operation

iliac stenting

Abstract:

Purpose: Was to observe the immediate and long-term results of hybrid operations in multilevel atherosclerotic lesions of aorto-iliac(AIS) and femoral-popliteal segments (FPS). Article describes the method of the hybrid intervention in the aorto-iliac segment

Materials and Methods: For the period of 2007-2011 - 40 patients with multilevel lesions of iliac arteries and lower limb arteries underwent hybrid operations. 57.5% of patients had aorto-iliac segment disease, classified as TASC C, and 42,5% - TASC D. Lesions of femoral-popliteal segment was divided in the following order: TASC A - 15,0%, TASC B - 35,0%, TASC C - 42,5% and TASC D - 7,5%. We applied loop endarterectomy with stenting for the correction of the aorto-iliac lesions. For arterial outflow correction we applied surgical operations. Follow-up period has been traced for 3 years.

Results: Primary technical success was achieved in 97.5%. Complications of the immediate postoperative period were noted in 15%. Long-term results were traced for 3 years in 70% of patients. Three-year assisted patency of aorto-iliac segment was 89%. All complications have been corrected only by endovascular procedure. Three-year cumulative patency of femoral-popliteal segment was 87%.

Conclusions: This technique allows achieving the best results in reducing lower limb ischemia. Simultaneous correction of both - inflow and outflow segments improved long-term results of each of the reconstruction. The method shows its effectiveness in patients with TASC C and TASC D lesions of aorto-iliac segment. Reduction of surgical trauma significantly affects the results in group of high risk patients.

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