Endovascular Treatment For TASCⅡ-C And TASCⅡ-D Type’ Arteriosclerosis Obliterans Of Lower Limbs: An Analysis Of 46 Cases

Object: The aim of this retrospective study is to collect 46 patients(53 limbs) who diagnosed with TASCⅡ-C and TASCⅡ-D type’ ASO and hospitalized between January 2014 and June 2015 in Vascular surgery department of First Affiliated Hospital of Fujian Medical University medical records and postoperative follow-up data, to summarize experience of Endovascular treatment for patients and to assess the clinical efficacy,safety,and clinical results of endovascular therapy in patients with TASCⅡ-C and TASCⅡ-D type’ arteriosclerosis obliterans.(ASO)Methods: Summary experience of Endovascular treatment of 46 patients(53 limbs) who diagnosed with TASCⅡ-C and TASCⅡ-D type’ ASO and hospitalized between January 2014 and June 2015 in Vascular surgery department medical records and postoperative follow-up data.collectting the perioperative risk factors, clinical classification, clinical symptoms, laboratory examinations and surgical conditions and other relevant information,analyzing the technical success rate,clinical success rate,the incidence of complication and the mortality rate.Patients were classified based on symptores,TASC Classification for the purpose to observe the cumulative primary patency rate,the cumulative secondary intervention rate, limb salvage rate and survival rate of different periods and to assess the clinical efficacy,safety,and clinical results of endovascular therapy in patients with TASCⅡ-C and TASCⅡ-D type’ arteriosclerosis obliterans.Result: 1. There are 46 cases(53 limbs) patients who diagnosed TASCⅡ-C and TASCⅡ-D type’ arteriosclerosis obliterans receiving endovascular treatment, 1 case(1 limb) endovascular treatment failure, before the diverted knee amputation died of multiple organ failure, more than 45 cases(52 limbs) were successful revascularization, The technical success rate was 98.1%(52 of 53 limbs). 2. All limbs mean preoperative ABI 0.52 ± 0.17, after increased to 0.97± 0.15, comparison between the two P <0.01, there was statistically significant. 3. 45 cases(52 limbs) revascularization succeed,5 cases(5 limbs) had to amputated due to poor outflow tract, One patient(a limb) died in MODS before amputation. 47 limbs have varying degrees of improvement in clinical symptoms, the clinical success rate was 88.7%(47 of 53 limbs),including 34 limbs(72.3%)have significant improved in clinical symptoms,moderate improvement in nine(19.1%); mild improvement in four(8.5%); 4.The mortafity rate was 4.3%(2/46) and perioperative complication rate was 23.91%(11/46).5. The cumulative primary patency rates of 3,6,12,15,18 months after operation were 89.4%,83.0%,70.3%,66.6% and 60.5% respectively, The cumulative secondary intervention rate of 3,6,12,15,18 months after operation were 10.6%,17.0%,27.7%,29.8% and 31.9% respectiely. The limb salvage rates and the survival rate of 1 year after operation were 100%.Conclusions:Endovascular treatment for TASCⅡ-C and TASCⅡ-D type’ ASO patient is reliable and effective.Using Catheter-directed thrombolysis(CDT) and Subintimal angioplasty(SIA) can improve the technical success rate in operation.Endovascular treatment is suitable for all types of patients, Especially suitable for difficult to tolerate surgical bypass surgery, peripheral arterial disease severe TASCⅡ C and TASCⅡ D-type patients. Because of invasive, fewer complications,safety etc.