Fate Of Collateral Vessels Following Endovascular Treatment Of Infra-inguinal Artery

As the rapid development of endovascualr technology and instrument,more and more arterial diseases can be treated by endovascular treatment.The technology of balloon dilatation and stent implantation in endovascular treatment of lower extremity artery are much more available.However,not enough attentions are payed on the protection of collateral vessels.In this study,we applied retrospective analysis on the imaging datas of clinical cases to evaluate the fate of collateral vessels adjacent to and within the target lesion following endovascular treatment of infra-inguinal artery by CreaLife Dicom Viewer,in order to provide better technical support on endovascular treatment.Objective:To analyze and summarize the fate of collateral vessels during endovascular treatment of infra-inguinal artery.Methods:A retrospective reviw of the 60 imaging datas following endovascular treatment of infra-inguinal artery carried out between Aug.2005 and Sep.2008 at our institution.The target vessel was divided into three parts,proximal area,distal area and lesion area.The number of the collateral vessels in these three areas were counted by CreaLife Dicom Viewer.Then we used the CHESS statistical software to analysis all datas.Results:1,The actual study of 57 cases,44 males,13 females,35 occlusions,22 stenoses,20 cases of balloon dilatation alone,37 cases of stent implantation.2,There is a significant difference of total collateral vessels in proximal area between pre-operative group and post-operative group,P＜0.05,but in distal area, no significant difference between pre-operative group and post-operative group, P＞0.05.3,In three areas of stenosis cases,no significant difference between pre-operative group and post-operative group,P＞0.05.4,In occlusion cases,there is a significant difference of collateral vessels in proximal area between pre-operative group and post-operative group,P＜0.05,but in distal area,no significant difference between pre-operative group and post-operative group,P＞0.05.5,there are both no significant difference of collateral vessels in sacrifice ratio and re-open ratio between femoral arteries group and in-below the knees arteries group,P＞0.05,but in distal area,no significant difference between pre-operative group and post-operative group,P＞0.05.6,In three areas of balloon dilatation cases,no significant difference between pre-operative group and post-operative group,P＞0.05.7,In stent implantation cases,there is a significant difference of total collateral vessels in proximal area between pre-operative group and post-operative group,P＜0.05,but in distal area,no significant difference in distal area and lesion area between pre-operative group and post-operative group, P＞0.05.8,There is no significant difference of collateral vessels in sacrifice ratio ratio between balloon dilatation group and stent implantation group,P＞0.05.Conclusion:In endovascular treatment of infra-inguinal artery,the sacrifice of collateral vessels mainly occurs in proximal area,in particular the occlusion cases or stent implantation cases.In all areas of stenosis cases and balloon dilatation cases,there is no significant difference between pre-operative and post-operative. No significant difference in collateral vessels between balloon dilatation alone and stent implantation.SIA may open new collaterals within occluded segments.No significant difference in collateral vessels between femoral arteries group and in-below the knees arteries.The low-risk of collateral vessels in endovascular treatment of infra-inguinal artery was confirmed,but the protection of the collateral vessels in proximal area is still to be more attention.