Jian Guan1, Yang Peng2, Longyuan Ouyang2, Chang Li2, Wenhao Fu2, Canhui Sun2, Xuhui Zhou3. 1. Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, No.58 Zhongshanerlu Road, Guangzhou, Guangdong, People's Republic of China. guanj6@mail.sysu.edu.cn. 2. Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, No.58 Zhongshanerlu Road, Guangzhou, Guangdong, People's Republic of China. 3. Department of Radiology, The Eighth Affiliated Hospital, Sun Yat-Sen University, No.3025 Shennanzhonglu Road, Shenzhen, Guangdong, People's Republic of China. zhouxuh@mail.sysu.edu.cn.
Abstract
PURPOSE: The aim of the study was to compare the hemodynamic effects of endoluminal and open surgical treatment of chronic Leriche syndrome using arterial collaterals on CTA as a surrogate parameter. MATERIALS AND METHODS: This retrospective, single-center study included 30 patients with chronic Leriche syndrome. Fourteen patients underwent intraluminal stent implantation (endo group), and sixteen underwent surgical bypass grafting (surgical group). CTA was performed pre- and postoperatively, and a series of evaluation parameters (a1: sum of area of the systemic collateral pathways in the abdominal wall before operation, a2: sum of area of the systemic collateral pathways in the abdominal wall after operation, ar: area of lumen of the stent or artificial vessel, BSR: post- and preoperative blood supply ratio = (a2 + ar)/a1, RR: reduction rate of systemic collateral arteries after the operation = (a1-a2)/a1) were defined to quantitatively evaluate the hemodynamic effects of the treatments. Short-term clinical outcomes, including improvement of symptoms, postoperative complications and in-hospital stay, were also collected. Then, the effects of the two operations were compared. RESULTS: There was no significant difference in the baseline (a1, p = 0.301) and postoperative (a2, p = 0.802) collateral arteries, as well as BSR (p = 0.088) and RR (p = 0.592) between endo and surgical groups. There was also no significant difference in short-term clinical outcomes between the two groups. CONCLUSION: Our limited series suggests that intraluminal stent implantation may not be inferior to surgical bypass grafting regarding the undifferentiated short-term clinical outcomes as well as the chosen hemodynamic surrogate parameters.
PURPOSE: The aim of the study was to compare the hemodynamic effects of endoluminal and open surgical treatment of chronic Leriche syndrome using arterial collaterals on CTA as a surrogate parameter. MATERIALS AND METHODS: This retrospective, single-center study included 30 patients with chronic Leriche syndrome. Fourteen patients underwent intraluminal stent implantation (endo group), and sixteen underwent surgical bypass grafting (surgical group). CTA was performed pre- and postoperatively, and a series of evaluation parameters (a1: sum of area of the systemic collateral pathways in the abdominal wall before operation, a2: sum of area of the systemic collateral pathways in the abdominal wall after operation, ar: area of lumen of the stent or artificial vessel, BSR: post- and preoperative blood supply ratio = (a2 + ar)/a1, RR: reduction rate of systemic collateral arteries after the operation = (a1-a2)/a1) were defined to quantitatively evaluate the hemodynamic effects of the treatments. Short-term clinical outcomes, including improvement of symptoms, postoperative complications and in-hospital stay, were also collected. Then, the effects of the two operations were compared. RESULTS: There was no significant difference in the baseline (a1, p = 0.301) and postoperative (a2, p = 0.802) collateral arteries, as well as BSR (p = 0.088) and RR (p = 0.592) between endo and surgical groups. There was also no significant difference in short-term clinical outcomes between the two groups. CONCLUSION: Our limited series suggests that intraluminal stent implantation may not be inferior to surgical bypass grafting regarding the undifferentiated short-term clinical outcomes as well as the chosen hemodynamic surrogate parameters.
Authors: Rulon L Hardman; Jorge E Lopera; Rex A Cardan; Clayton K Trimmer; Shellie C Josephs Journal: AJR Am J Roentgenol Date: 2011-09 Impact factor: 3.959
Authors: M M Marrocco-Trischitta; L Bertoglio; Y Tshomba; A Kahlberg; E M Marone; R Chiesa Journal: J Cardiovasc Surg (Torino) Date: 2012-06 Impact factor: 1.888