Clinical Research Of Endovascular Treatment Of Lower Limb Ischemia With Viabahn Endoprothesis

Objective: To evaluate the endovascular treatment of lower limb ischemia withViabahn Endoprothesis in short-term.Methods: These figures are retrospectively analyzed the treatment of17cases(17limbs) with arteriosclerotic occlusive disease from April2013to November2013in ourhospital. Mean age was68.8±8.1years (range,54-81years), there were13males(76.5%),4femals（23.5%）.The degree of ischemia was recorded by Rutherfordcategory: category2were2cases(11.8%),category3were5cases(29.4%),category4were5cases(29.4%),category5were5cases(29.4%).The condition of run-off vessels：5patients had0run-off vessel（29.4%），2patients had1run-off vessel（11.8%），4patients had2run-off vessels（23.5%），6patients had3run-off vessels（35.3%）.Thecondition of comorbidities:11patients had hypertension(64.7%),8patients had diabetesmellitus(47.1%),8patients had hyperlipidemia(47.1%),10patients had coronary arterydisease(58.8%).Lesions were divided in vascular segment: There were2limbs with iliaclesions(11.8%),11limbs with femoral popliteal artery(64.7%),4limbs withmulti-segment lesions such as iliofemoral popliteal artery(23.5%),6of them were therestenosis or occlusion after bare stent implantation(35.3%). The average ABI beforethe operation was0.42±0.23.we calculated CTA and(or) color Doppler ultrasound toknow the condition of lesions in the lower limbs and calculate the diameter of the lesion.Lesion vessels were used VASIR(Viabahn-Assisted Subintimal Recanalization) technique in most of the cases. we calculated ABI after the operation. Follow-up1month,3months, and6months we evaluated patency with color Doppler ultrasound orCTA and therapeutic efficiency through the improvement of Rutherford category andlimb salvage rate.Results: The all success rate of17limbs was100%(17/17). The average ABI afterthe operation was0.76±0.21, which compared with the average ABI before theoperation increased significantly（P＜0.05﹚. The limb salvage was100%(17/17) afterfollow-up1month,100%(17/17) after follow-up3months,100%(17/17) afterfollow-up6months. The postoperative1month primary patency was100%(17/17),3months primary patency was94.1%(16/17), secondary patency was94.1%(16/17),6months primary patency was70.6%(12/17), secondary patency was88.2%(15/17).Conclusion:1.The treatment of lower limb ischemia with Viabahn Endoprothesishas a good technical success rate, a satisfied limb salvage rate and relatively highpatency rate.2.Choosing the appropriate diameter of Viabahn Endoprothesis，ensuring abetter run-off below the knee can improve the patency rate and limb salvage rate.