|Long-term results of combined common femoral endarterectomy and iliac stenting/stent grafting for occlusive disease.|
|PMID: 18572359 Owner: NLM Status: MEDLINE|
|BACKGROUND: Common femoral artery (CFA) endarterectomy with iliac stenting or stent grafting can be an alternative to traditional open surgery in patients with aortoiliac occlusive disease. We report the long-term outcomes of this approach.
METHODS: Patients undergoing CFA endarterectomy with simultaneous iliac stenting/stent grafting between 1997 and 2006 were retrospectively reviewed. Technical success, clinical and hemodynamic outcomes, and 5-year patency using life-table methodology were determined. Factors associated with reintervention and mortality were determined by logistic regression analysis.
RESULTS: A total of 171 patients (mean age, 67 +/- 10 years; 38% female; 35% diabetic) underwent 193 CFA endarterectomies and iliac stent/stent grafting. Indications were rest pain (32%), tissue loss (22%), and claudication (46%). External iliac artery (EIA) lesions were present in 39%, and combined common iliac artery (CIA) and EIA lesions were seen in 61% of patients. Complete CIA/EIA occlusions were present in 41% of patients. Stent grafts were used in 41% of patients. Technical success occurred in 98% of patients. Clinical improvement was seen in 92% of patients. Mean ankle-brachial index increased from 0.38 +/- 0.32 to 0.72 +/- 0.24. Median length of stay was 2 days (range, 1-51 days). Thirty-day mortality was 2.3% and 5-year survival was 60%. Five-year primary, primary-assisted, and secondary patencies were 60%, 97%, and 98% respectively. Endovascular reintervention was required in 14% of patients; inflow surgical procedures were required in 10%. By logistic regression analysis, use of stent grafts compared with bare stents was associated with significantly higher primary patency (87% +/- 5% vs 53% +/- 7%; P < .01).
CONCLUSION: Combined CFA endarterectomy with iliac intervention yield acceptable long-term results. The use of stent grafts compared with bare stents is associated with improved primary patency.
|Robert W Chang; Philip P Goodney; Jennie H Baek; Brian W Nolan; Eva M Rzucidlo; Richard J Powell|
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|Type: Journal Article Date: 2008-06-24|
|Title: Journal of vascular surgery Volume: 48 ISSN: 1097-6809 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2008 Aug|
|Created Date: 2008-07-22 Completed Date: 2008-08-22 Revised Date: 2012-10-03|
Medline Journal Info:
|Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States|
|Languages: eng Pagination: 362-7 Citation Subset: IM|
|Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.|
|APA/MLA Format Download EndNote Download BibTex|
Aged, 80 and over
Analysis of Variance
Angiography, Digital Subtraction / methods
Arterial Occlusive Diseases / mortality, radiography, surgery*
Balloon Dilation / methods*
Combined Modality Therapy
Endarterectomy / methods*
Femoral Artery / surgery*
Intermittent Claudication / diagnosis, surgery
Severity of Illness Index
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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