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Outcomes of endovascular treatment of chronic total occlusion of the infrarenal aorta

 Tae-Hoon Kim  ;  Young-Guk Ko  ;  Won-Heum Shim  ;  Yangsoo Jang  ;  Myeong-Ki Hong  ;  Donghoon Choi  ;  Jung-Sun Kim  ;  Ung Kim 
 Journal of Vascular Surgery, Vol.53(6) : 1542-1549, 2011 
Journal Title
 Journal of Vascular Surgery 
Issue Date
BACKGROUND: Few reports have been published on the outcomes of endovascular therapy in chronic total occlusion of the aorta. METHODS: Endovascular treatment was attempted in 49 patients (40 men and nine women; aged 64.1 ± 10.9 years) with infrarenal aortic occlusion between January 1995 and December 2009. The first attempt at wire passage and balloon angioplasty was usually performed by an antegrade approach through the brachial artery. Stents were implanted with or without intra-arterial administration of thrombolytic agents. We investigated the immediate and midterm outcomes of endovascular therapy for chronic infrarenal aortic occlusions. RESULTS: Technical success was achieved in 40 patients (81.6%). Procedural failures were due to wire passage failure in eight patients and to embolization and spinal cord infarction in one. Stents were implanted in 97.5% of patients. Major complications occurred in eight patients (16.3%): two neurologic events (spinal and cerebral infarction), two cases of jailed renal artery after stenting, and one case each of periprocedural death from pneumonia, distal embolization requiring embolectomy, iliac artery rupture requiring implantation of covered stents, and access site pseudoaneurysm treated with surgery. In patients treated successfully, the primary patency rate was 88.4% at 1 year and 80.1% at 3 years. The major amputation rate was 0%. Seven patients (17.5%) required repeat intervention (n = 5) or bypass surgery (n = 2) during the follow-up period. CONCLUSION: Endovascular therapy of infrarenal aortic occlusion was feasible in most cases, and midterm patency was favorable. However, because of relatively high procedurally related complication rates, cautious selection of patients and appropriate preventive measures are necessary to improve immediate outcomes.
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
고영국(Ko, Young Guk) ; 김중선(Kim, Jung Sun) ; 김태훈(Kim, Tae-Hoon) ; 심원흠(Shim, Won Heum) ; 장양수(Jang, Yang Soo) ; 최동훈(Choi, Dong Hoon) ; 홍명기(Hong, Myeong Ki)
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