[Results of endovascular revascularization of combined lesions of aortic bifurcation and iliac arteries in immediate and remote periods of follow up].

Abstract

Background: The use of endovascular methods of treatment for steno-occlusive lesions of the aortic bifurcation and common iliac arteries is the subject of discussions. The 'gold standard' of surgical treatment in Leriche syndrome is aortofemoral bypass grafting, however, it is associated with a risk for developing surgical complications up to 25%.

Objective: The purpose of this study was to evaluate the immediate and remote results of patency of the aortic bifurcation and iliac arteries after endovascular reconstruction.

Patients and methods: We retrospectively analyzed outcomes of treatment of patients operated on between January 2012 and December 2018 using the kissing-stenting of the aortic bifurcation for TASC-II C and D atherosclerotic lesions, assessing the parameters in the early postoperative period (clinical success, procedure-related complications, revascularization, in-hospital MACE and MALE) and in the remote period (primary patency, secondary patency, survival, limb salvage).

Results: Lower primary patency of the reconstruction zone was statistically significantly associated with such factors as 'exit' of proximal portions of the stents above the aortic bifurcation, their diameter being less than 7 mm, and the presence of thrombotic masses in the infrarenal portion of the aorta (according to the findings of computed tomography). In elderly patients, the risk for amputation after surgery turned out to be significantly higher.

Conclusion: The use of kissing-stenting of the aorta and iliac arteries yielded satisfactory results both from the technical point of view in the early period and in preservation of late patency. However, the revealed predictors of primary patency loss suggest the necessity of more thorough planning of the procedure.