Comparison Of Therapeutic Effects Between Aortofemoral Bypass And Percutaneous Transluminal Angioplasty For TASC C-D Aortoiliac Occlusive Disease

Purpose:As for TASC C-D aortoiliac occlusive disease patients,there are two kinds of therapy to choose: Aortofemoral Bypass and Percutaneous Transluminal Angioplasty.The comparison between Aortofemoral Bypass and Percutaneous Transluminal Angioplastyand endovascular therapy in1 year,2 years and 5 years of long term patency,perioperative mortality,incidence of complications,improvement of clinical symptoms,changes of ABI values before and after operation,re-intervention rate,etc.can tell a difference to the treatment of TASC C-D aortoiliac occlusive disease.Background:Aortoiliac Occlusive Disease is a common type of peripheral artery disease(PAD).The incidence of the disease is increasing year by year.Relative to classic Aortofemoral Bypass operation,Percutaneous transluminal angioplasty is more and more used for its safety and convenience,but for patients with complicated Aortoiliac Occlusive Disease,the treatment effect has not yet been confirmed.Methods:A total data of Aortoiliac Occlusive Disease patients in Japan Union Hospital vascular surgery from 2004 to 2014,and they were divided into two groups,including Aortofemoral Bypass surgery(Bypass group)cases,Percutaneous Transluminal Angioplasty(intervention group)cases.Therewere 81 cases in the bypass group and 102 cases in the interventional group.There were 112 males and 71 females.Age 52-81 years(61.12 ±9.38 years)Inclusion criteria: 1,medical history: 3 months,for the first time related surgical treatment;2,clinical symptoms: Chronic onset,patients of Fontaine grade II and above;3,Patients with distal outflow tract.The ABI and clinical improvement were analyzed before and after operation.Follow up survey was carried out on patients.Patients were required to receive Doppler ultrasound after 1 year,2 years and 5 years after operation,If the rate of vascular stenosis is greater than 50%,it is considered as narrowing.Through SPSS19.0 software,two groups of samples were tested by chi square test and t test for the above situation,and there were significant differences when P < 0.05.Results:1.The one-stage patency rate in the bypass group was 92%,and that in the intervention group was 67%.The chi-square test was performed on the two groups(P < 0.05).There was no significant difference between bypass group and interventional group in one-year and two-year patency rate.The rate of re-intervention in bypass group was lower than that in intervention group.2.the clinical symptoms of Bypass group and interventional group were significantly improved,the preoperative ABI value was 0.45 ±0.11,the postoperative ABI value was less than 0.05,the preoperative ABIvalue was 0.42 ±0.13,and the postoperative ABI value was less than0.05 in the Bypass group(P < 0.05).3.There were 3 cases of death in the bypass group and no death cases in the interventional group.The incidence of severe complications in the bypass group was significantly higher than that in the interventional group(P< 0.05),and the incidence of severe complications in the bypass group was higher than that in the interventional group(P <0.05).Conclusion:Endovascular therapy has the characteristics of low incidence of severe complications and low mortality,and can be used in the treatment of patients with TASC C-D main iliac artery occlusion,and has a good long-term patency rate and re-intervention rate for aorta-bilateral femoral artery bypass.It is still the gold standard for the treatment of TASC C-D main iliac artery occlusive disease.