Endovascular treatment of infrarenal aortoiliac occlusive diseases

Objective: To evaluate the therapeutic effect of endovascular treatment for infrarenal (below the level of the renal artery) aortoiliac occlusive diseases. Methods: The clinical data of 21 patients with infrarenal aortoiliac occlusive disease, who were admitted to authors' hospital during the period from January 2013 to June 2015 to receive endovascular minimally-invasive treatment and reconstruction of blood circulation, were retrospectively analyzed. All patients underwent endovascular stenting angioplasty. Follow-up examination was conducted at 3, 6, 9 and 12 months after the treatment, and CT angiography was performed once a year. Results: Catheter-directed thrombolysis lasting for 24 hours was carried out in all 21 patients. Bare metal stents of inverted Y type were used to make endovascular reconstruction in 11 patients, and a total of 41 aortic bare metal stents and peripheral self-expanding stents were implanted. Covered stents in kissing configuration were employed in 2 patients, and a total of 4 Gore Viabahn stents were used. Endovascular reconstruction with Gore Excluder covered stent implantation was performed in 8 patients, the technical success rate was 100%. No death or severe complications occurred in perioperative period, and the symptoms of lower limb ischemia were improved in all patients. The patients were followed up for 6-24 months, no stent displacement or endoleak was observed. One patient in bare stent treatment group developed iliac artery stent thrombosis in 8 months after the treatment, and conservative treatment with medication was adopted. One patient in Gore Excluder covered stent treatment group developed unilateral distal iliac artery stenosis in 18 months after the treatment, and the artery returned unobstructed after angioplasty with bare metal stent. All the other grafts remained patent in follow-up period. Conclusion: For infrarenal aortoiliac occlusive diseases, endovascular minimally-invasive treatment has excellent short-term and mid-term effect, however, in order to improve the operative success rate and to reduce the incidence of complications, proper selection of individualized treatment plan is recommended. (authors)