Endovascular Treatment Of Arteriosclerosis Obliterans Of Lower Extremities

ObjectiveTo explore the approach to the endovascular treatment for lower limb ischemia and improve therapeutic effect of peripheral arterial disease.Methodswe conducted a retrospective analysis on 54 patients of atherosclerotic occlusive disease. Underwent endovascular treatment from December 2004 to 2007 in the Second Hospital of Tianjin Medical University.39 male and 15 female patients, a mean age of 67.2 years (range 51-85 years).According to the Fontaine stages,there were 22 stage II b patients, 15 stage III patients, 17 stagre IV patients,31 patients( III + IV )with critical limb ischemia(57.4%). Isolated lesions in 24 patients and multi-level lesions in 30 patients. 14 patients underwent balloon dilatation and 24 patients were performed balloon dilatation and stent placement. A total of 53 stents was placement in 24 patients, 39 iliac arterial stents and 14 superficial femoral arterial stents,3 patients underwent prosthetic femoral-popliteal bypass combined with endovascular treatment. 20 patients accept the procedure of introvascular ultrasound thrombolisis.ResultsIn the iliac artery ,the acute patency rate was 94.4%,technical success rate was 100%.,the rate of clinical improve of symptems was 100%. The 1- and 2- year primary patency was 100% and 77.8%. In the infrainguinal artery,the acute patency rate of was 87.1%,technical success rate was 85.1%, the rate of clinical improve of symptoms was 92.5%, the primary and secondary patency at 1 and 2 year were 60% and 73.3%,37.3% and 50%. The success rate of intravascular ultrasound thrombolysis was 90%.Anklebrachial index of preoperation is 0.72±0.19 and postoperation is 0.40±0.20, there was significant different procedure.ConclusionsEndovascular treatment for iliac arterial occlusive disease can be used as the first choice. The therapy is a safe and effective method for infrainguinal arterial occlusive disease, and is preferential in patients with critical limb ischemia especially. Intravascular ultrasound thrombolysis improve outcomes of endovascular treatment in the patients with extensive and complex lesions.