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YÜZEYEL FEMORAL ARTER STENOZ VE OKLÜZYONLARINDA ENDOVASKÜLER TEDAVİ Endovascular Treatment of Superficial Femoral Artery Stenosis and Occlusions

Year 2019, Volume: 9 Issue: 2, 138 - 145, 28.06.2019

Abstract

ÖZET
Amaç: Bu çalışmada, yüzeyel femoral arter stenoz ve oklüzyonlarında endovasküler yolla tedavi edilen hastalarda
deneyimin, teknik başarının ve periprosedüral komplikasyonlara yaklaşımın sunulması amaçlandı.
Gereç ve Yöntemler: Haziran 2012 ve Aralık 2018 tarihleri arasında hastanemiz girişimsel radyoloji ünitesine
yürüme ağrısı ve kritik ayak iskemisi nedeniyle yönlendirilen, yüzeyel femoral arterde stenoz veya oklüzyon
saptanan 40 hastanın (11 kadın, 29 erkek) kayıtları retrospektif olarak incelendi. Hastalar tedavi kararı öncesinde
klinik öykü ve bulgularının yanı sıra Doppler US, BT anjiyo veya dijital subtraksiyon anjiyografi ile
değerlendirildi. İşlemi kabul eden hastalara endovasküler tedavi ile primer perkütan translüminal anjiyoplasti
ve ihtiyaç halinde stentleme uygulandı. İşlem sonrası hastalar erken dönem komplikasyonlar açısından
takip edildi.
Bulgular: Çalışmaya dahil edilen yüzeyel femoral arterde oklüzyon veya stenoz olan hastalar endovasküler
yöntemlerle tedavi edildi. Ortalama oklüde segment uzunluğu 132.3 mm ölçüldü (aralık=15-280 mm). Primer
PTA ile tedavi, stenotik ve oklüde segmentler geçildikten sonra hastaların %80’inde başarıyla gerçekleştirildi.
Yeterli lümen patensi sağlanamayan veya PTA’ya yanıtsız diseksiyon gelişen %20 hastada ise ek olarak
süper elastik özel nitinol örgülü kendiliğinden açılabilen stent uygulanarak patensi sağlandı. Endovasküler
tedavinin teknik başarı oranı %100 olarak hesaplandı. Dört hastada diseksiyon ve bir hastada distal emboli
olmak üzere toplam beş hastada (%12.5) işlem esnasında komplikasyon gelişti ve bu hastalar yine endovasküler
yöntemlerle tedavi edildi.
Sonuç: Yüzeyel femoral arterde perkütan translüminal anjiyoplasti ve stentleme işleminin teknik başarı
oranları yüksek ve komplikasyon oranları düşüktür. Gelişen malzeme kalitesi ve teknikler ile endovasküler
yöntemler ile tedavi edilebilen hasta sayısı daha da artacaktır.
Anahtar Kelimeler: Balon anjiyoplasti; Endovasküler prosedürler; Yüzeyel femoral arter; Stentler
ABSTRACT
Aim: In this study, it is aimed to present the experience, technical success and management of the
periprocedural complications in patients treated with endovascular treatment of superficial femoral artery
stenosis and occlusion.
Materials and Method:A total of 40 patients (11 women, 29 men) with superficial femoral artery stenosis
or occlusion between June 2012 and December 2018 referred to our interventional radiology unit with
symptoms of claudication and critical limb ischemia were retrospectively analyzed. The patients were
evaluated with Doppler US, CT angiography or digital subtraction angiography in addition to clinical history
and findings before treatment decision. The patients who accepted the procedure underwent endovascular
treatment with primary percutaneous transluminal angioplasty and stenting if necessary. Patients were
followed up for early complications.
Results: The patients with occlusion or stenosis in the superficial femoral artery were treated with
endovascular methods. The mean length of the occluded segment was measured as 132.3 mm (range =
15-280 mm). Treatment with primary PTA was successfully performed in 80% of patients after crossing
the stenotic and occluded segments. Lumen patency in 20% of the patients with a resistant lesion or
unresponsive dissection to PTA was achieved by self-expandable superelastic nitinol stent. The technical
success rate of endovascular treatment was 100%. Complications occurred in five patients (12.5%) and
treated with endovascular methods, including dissection in four patients and distal embolism in one patient.
Conclusion: Percutaneous transluminal angioplasty and stenting procedures of the superficial femoral
artery are performed with high technical succes and low complication rates. The number of patients treated
with endovascular methods will increase with developing material quality and techniques.
Key words: Balloon angioplasty; Endovascular procedures; Superficial femoral artery; Stents

References

  • 1. Tadros RO, Vouyouka AG, Ting W, Teodorescu V, Kim SY, Marin ML, Faries PL. A Review of Superficial Femoral Artery Angioplasty and Stenting. J Vasc Med Surg 2015; 3(1):1-5 2. Drachman DE. Endovascular Treatment of the Superficial Femoral Artery: When Nothing Is Actually Quite Something. J Am Coll Cardiol. 2019;73(6):680-683. 3. Yokoi Y, Fukuda K, Fujihara M, Higashimori A, Kawarada O. Angiography and Endovascular Therapy for Femoropopliteal Artery Disease, Angiography and Endovascular Therapy for Peripheral Artery Disease. IntechOpen 2017:3 DOI: 10.5772/67181 4. Rose G. Bulletin of W.H.O. 1962;27:645-57. Hirsch AT, et al. J Am Coll Cardiol. 2006;47:1239–312. 5. Sato K, Iida O, Takahara M, Soga Y, Suzuki K, Tanigawa T, Ito M, Uematsu M. Effect of perioperative complications after endovascular therapy in patients with peripheral artery disease due to femoropopliteal lesions. J Vasc Surg. 2015 May;61(5):1272-7. 6. Hiatt WR. Medical treatment of peripheral arterial disease and claudication. N Engl J Med. 2001 May 24;344(21):1608-21. 7. Adili F, Balzer K, Betz T, Billing A, Böckler D, Brixner D, et al. A current practice of first-line treatment strategies in patients with critical limb ischemia. J Vasc Surg 2015; 62: 965–973. 8. Powell RJ. Endovascular Treatment in the Superficial Femoral Artery: Which Devices, Where? Seminars in Vascular Surgery. 2008;21(4):180-185. 9. Dake MD, Ansel GM, Jaff MR, et al. Paclitax eleluting stents show superiority to balloon angioplasty and bare metal stents in femoropopliteal disease: twelve-month Zilver PTX randomized study results. Circ Cardiovasc Interv 2011;4:495–504. 10. Rosenfield K, Jaff MR, White CJ, et al. Trial of a paclitaxel-coated balloon for femoropopliteal artery disease. N Engl J Med 2015;373:145–53
Year 2019, Volume: 9 Issue: 2, 138 - 145, 28.06.2019

Abstract

References

  • 1. Tadros RO, Vouyouka AG, Ting W, Teodorescu V, Kim SY, Marin ML, Faries PL. A Review of Superficial Femoral Artery Angioplasty and Stenting. J Vasc Med Surg 2015; 3(1):1-5 2. Drachman DE. Endovascular Treatment of the Superficial Femoral Artery: When Nothing Is Actually Quite Something. J Am Coll Cardiol. 2019;73(6):680-683. 3. Yokoi Y, Fukuda K, Fujihara M, Higashimori A, Kawarada O. Angiography and Endovascular Therapy for Femoropopliteal Artery Disease, Angiography and Endovascular Therapy for Peripheral Artery Disease. IntechOpen 2017:3 DOI: 10.5772/67181 4. Rose G. Bulletin of W.H.O. 1962;27:645-57. Hirsch AT, et al. J Am Coll Cardiol. 2006;47:1239–312. 5. Sato K, Iida O, Takahara M, Soga Y, Suzuki K, Tanigawa T, Ito M, Uematsu M. Effect of perioperative complications after endovascular therapy in patients with peripheral artery disease due to femoropopliteal lesions. J Vasc Surg. 2015 May;61(5):1272-7. 6. Hiatt WR. Medical treatment of peripheral arterial disease and claudication. N Engl J Med. 2001 May 24;344(21):1608-21. 7. Adili F, Balzer K, Betz T, Billing A, Böckler D, Brixner D, et al. A current practice of first-line treatment strategies in patients with critical limb ischemia. J Vasc Surg 2015; 62: 965–973. 8. Powell RJ. Endovascular Treatment in the Superficial Femoral Artery: Which Devices, Where? Seminars in Vascular Surgery. 2008;21(4):180-185. 9. Dake MD, Ansel GM, Jaff MR, et al. Paclitax eleluting stents show superiority to balloon angioplasty and bare metal stents in femoropopliteal disease: twelve-month Zilver PTX randomized study results. Circ Cardiovasc Interv 2011;4:495–504. 10. Rosenfield K, Jaff MR, White CJ, et al. Trial of a paclitaxel-coated balloon for femoropopliteal artery disease. N Engl J Med 2015;373:145–53
There are 1 citations in total.

Details

Primary Language Turkish
Journal Section Original Research
Authors

Hasanali Durmaz

Publication Date June 28, 2019
Published in Issue Year 2019 Volume: 9 Issue: 2

Cite

APA Durmaz, H. (2019). YÜZEYEL FEMORAL ARTER STENOZ VE OKLÜZYONLARINDA ENDOVASKÜLER TEDAVİ Endovascular Treatment of Superficial Femoral Artery Stenosis and Occlusions. Bozok Tıp Dergisi, 9(2), 138-145.
AMA Durmaz H. YÜZEYEL FEMORAL ARTER STENOZ VE OKLÜZYONLARINDA ENDOVASKÜLER TEDAVİ Endovascular Treatment of Superficial Femoral Artery Stenosis and Occlusions. Bozok Tıp Dergisi. June 2019;9(2):138-145.
Chicago Durmaz, Hasanali. “YÜZEYEL FEMORAL ARTER STENOZ VE OKLÜZYONLARINDA ENDOVASKÜLER TEDAVİ Endovascular Treatment of Superficial Femoral Artery Stenosis and Occlusions”. Bozok Tıp Dergisi 9, no. 2 (June 2019): 138-45.
EndNote Durmaz H (June 1, 2019) YÜZEYEL FEMORAL ARTER STENOZ VE OKLÜZYONLARINDA ENDOVASKÜLER TEDAVİ Endovascular Treatment of Superficial Femoral Artery Stenosis and Occlusions. Bozok Tıp Dergisi 9 2 138–145.
IEEE H. Durmaz, “YÜZEYEL FEMORAL ARTER STENOZ VE OKLÜZYONLARINDA ENDOVASKÜLER TEDAVİ Endovascular Treatment of Superficial Femoral Artery Stenosis and Occlusions”, Bozok Tıp Dergisi, vol. 9, no. 2, pp. 138–145, 2019.
ISNAD Durmaz, Hasanali. “YÜZEYEL FEMORAL ARTER STENOZ VE OKLÜZYONLARINDA ENDOVASKÜLER TEDAVİ Endovascular Treatment of Superficial Femoral Artery Stenosis and Occlusions”. Bozok Tıp Dergisi 9/2 (June 2019), 138-145.
JAMA Durmaz H. YÜZEYEL FEMORAL ARTER STENOZ VE OKLÜZYONLARINDA ENDOVASKÜLER TEDAVİ Endovascular Treatment of Superficial Femoral Artery Stenosis and Occlusions. Bozok Tıp Dergisi. 2019;9:138–145.
MLA Durmaz, Hasanali. “YÜZEYEL FEMORAL ARTER STENOZ VE OKLÜZYONLARINDA ENDOVASKÜLER TEDAVİ Endovascular Treatment of Superficial Femoral Artery Stenosis and Occlusions”. Bozok Tıp Dergisi, vol. 9, no. 2, 2019, pp. 138-45.
Vancouver Durmaz H. YÜZEYEL FEMORAL ARTER STENOZ VE OKLÜZYONLARINDA ENDOVASKÜLER TEDAVİ Endovascular Treatment of Superficial Femoral Artery Stenosis and Occlusions. Bozok Tıp Dergisi. 2019;9(2):138-45.
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