Kenji Suzuki1, Yukiko Mizutani2, Yoshimitsu Soga3, Osamu Iida4, Daizo Kawasaki5, Yasutaka Yamauchi6, Keisuke Hirano7, Ryouji Koshida8, Daisuke Kamoi9, Junichi Tazaki10, Michiaki Higashitani11, Yoshiaki Shintani12, Terutoshi Yamaoka13, Shinya Okazaki14, Nobuhiro Suematsu15, Taketsugu Tsuchiya16, Yusuke Miyashita17, Norihiko Shinozaki18, Hiroki Takahashi19, Naoto Inoue2. 1. Department of cardiology, Saiseikai Central Hospital, Minato-ku, Tokyo, Japan k-y.suzuki@nifty.com. 2. Cardiovascular Center, Sendai Kousei Hospital, Sendai, Miyagi, Japan. 3. Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan. 4. Cardiovascular Division, Kansai Rosai Hospital, Nishinomiya, Hyogo, Japan. 5. Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. 6. Kikuna Memorial Hospital, Yokohama, Kanagawa, Japan. 7. Saiseikai Yokohama-City Eastern Hospital, Yokohama, Kanagawa, Japan. 8. Tokeidai Memorial Hospital, Sapporo, Hokkaido, Japan. 9. Nagoya Kyoritsu Hospital, Nagoya, Aichi, Japan. 10. Kyoto University Hospital, Kyoto, Kyoto, Japan. 11. Sakakibara Heart Institute, Fuchu, Tokyo, Japan. 12. Shin-Koga Hospital, Kurume, Fukuoka, Japan. 13. Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan. 14. Juntendo University Nerima Hospital, Nerima, Tokyo, Japan. 15. Japanese Red Cross Fukuoka Hospital, Minami-ku, Fukuoka, Japan. 16. Kanazawa Medical University Hospital, Kahoku, Ishikawa, Japan. 17. Shinshu University Hospital, Matsumoto, Nagano, Japan. 18. Tokai University Hospital, Isehara, Kanagawa, Japan. 19. Yamagata University Hospital, Iidanishi, Yamagata, Japan.
Abstract
BACKGROUND: Although there is increasing evidence of the effectiveness of endovascular therapy for complex aortoiliac (AI) occlusive disease, it is not universally applied to TASC D lesions. METHODS: A total of 2096 patients, 2601 limbs with AI occlusive disease, were enrolled. The lesions were categorized as TASC D (395) or TASC A-C (2206), and we compared baseline data, procedure, and follow-up result between the 2 groups. RESULTS: The success rate of the procedure was significantly lower in the TASC D group (91.6% vs 99.3%, P < .01), and more procedure complications occurred in the TASC D group (11.1% vs 5.2%, P < .01). The results of a 5-year follow-up revealed no significant difference in primary patency (77.9% vs 77.1%, P = .17) and major adverse cardiovascular and limb events (MACLE; 30.5% vs 33.4%, P = .42) between the 2 groups. A multivariate analysis revealed complications and critical limb ischemia are independent predictors of MACLE in the TASC D group. CONCLUSION: The success rate of the procedure was lower in the TASC D group. Complications were more frequent in the TASC D group, and they were related to MACLE.
BACKGROUND: Although there is increasing evidence of the effectiveness of endovascular therapy for complex aortoiliac (AI) occlusive disease, it is not universally applied to TASC D lesions. METHODS: A total of 2096 patients, 2601 limbs with AI occlusive disease, were enrolled. The lesions were categorized as TASC D (395) or TASC A-C (2206), and we compared baseline data, procedure, and follow-up result between the 2 groups. RESULTS: The success rate of the procedure was significantly lower in the TASC D group (91.6% vs 99.3%, P < .01), and more procedure complications occurred in the TASC D group (11.1% vs 5.2%, P < .01). The results of a 5-year follow-up revealed no significant difference in primary patency (77.9% vs 77.1%, P = .17) and major adverse cardiovascular and limb events (MACLE; 30.5% vs 33.4%, P = .42) between the 2 groups. A multivariate analysis revealed complications and critical limb ischemia are independent predictors of MACLE in the TASC D group. CONCLUSION: The success rate of the procedure was lower in the TASC D group. Complications were more frequent in the TASC D group, and they were related to MACLE.
Authors: Vladimir Cvetic; Dragan Sagic; Igor Koncar; Vladimir Kovacevic; Oliver Radmili; Zelimir Antonic; Borivoje Lukic; Nikola Aleksic; Lazar Davidovic; Djordje Radak Journal: PLoS One Date: 2019-10-02 Impact factor: 3.240