Analyze The Clinical Curative Effect Of Endovascular Treatment In Aortoiliac Occlusion Disease

Objective:To analyze the clinical effect and possible complications of the endovascular treatment in aortoiliac occlusion disease(AIOD),and to provide clinical reference for the treatment of disease.Methods:Eighty-three patients with aortoiliac occlusion disease were retrospectively analyzed from June 2014 to June 2017.Through a comprehensive analysis of every case,the patients were treated with percutaneous transluminal angiography(PTA),catheter-directed thrombolysis(CDT),stent implantation and other treatment methods.To analyze the clinical curative effect and related complications of AIOD.Results:Among 97 limbs that having been received treatments,according to TASC-? classification:there are 17 cases in grade A(20.5%),25 cases in grade B(30.1%),27 cases in grade C(32.5%),14 cases in grade D(16.9%).The major concomitant diseases include hypertension,coronary heart disease,diabetes,cerebral infarction and chronic renal insufficiency.8 cases(8 limbs)received PTA,7 cases(7 limbs)received PTA+CDT,14 cases(14 limbs)received CDT and secondary stenting,52 cases(66 limbs)received primary stenting,2 cases(2 limbs)received arterial embolectomy+endarterectomy.Kissing technique was used in 14 cases with aortoiliac artery occlusion.There was a significant improvement in the ankle brachial ratio(ABI)from(0.79±0.10)to(0.38±0.05)after surgery.Six of the 83 patients had related complications,the incidence was 7.2%,including acute in-stent thrombosis in 1 case(1.2%),distal artery embolism in 1 case(1.2%),puncture-associated complications in 1 case(1.2%),acute cerebral infarction in 1 case(1.2%).Postoperative renal insufficiency was worse in 2 patients.There were 47 patients with significant improvement in intermittent claudication during discharge and 14 patients with significant improvement in resting pain.The clinical symptoms of the remaining patients were reduced than before operation.With(22.8±5.5)months of an average follow-up time,1 year and 2 years patency rate is 93.6%and 84.2%respectively.1 case received amputation,1 case received toe cutting surgery,and the limbs retention rate was 97.9%.With 2 case death,and the cause of death was multiple organ dysfunction syndrome(MODS)caused by infection and acute cerebrovascular accident.During the follow-up time,patients with postoperative 1 week,6 months and 12 months after operation of ankle brachial index were0.84±0.06,0.81 ±0.04 and 0.79±0.05,compared with preoperative 0.38±0.05,P<0.05.Walking distance were respectively 320.3±16.3m,526.6±52.3m and 632.6±61.3,compared with preoperative 97.3 ±23.2m,P<0.05.Conclusion:Intracavitary therapy is a safe and effective treatment for AIOD with higher near-mid-term patency rate.It is an effective treatment with the characteristics of small trauma and simple operation,and the lower incidence of perioperative complications,especially which is suitable for aged patients with iliac artery occlusion.