İliyak arter ve infrainguinal arter tıkayıcı hastalığında hybrid strateji

Yıl 2017, Cilt: 8 Sayı: 2, 52 - 56, 08.06.2017

Ersin Sarıcam Yasemin Sağlam Osman Beton Bülent Kaya

https://doi.org/10.18663/tjcl.320031

Öz

Amaç: Periferik arter hastalığının tedavisi farklı tedavi
seçeneklerine sahiptir. Son zamanlarda hibrid tedavi yöntemi (endovasküler
tedavi artı cerrahi) alt ekstremite arter hastalığı tedavisinde
kullanılmaktadır.  Bu çalışmada iliyak
arter ve infrainguinal periferik arter hastalığında hibrid tedavi
incelenmiştir.

Gereç ve Yöntemler: Bu çalışma Ocak 2010 ile Ağustos
2015 yılları arasında tıkayıcı iliyak arter hastalığı olan ve endovasküler
tedavi yapılan 76 hastayı içermektedir. 56 hastaya sadece iliyak arter
endovasküler tedavi uygulanırken, 20 hastaya iliyak arter endovasküler tedaviye
ilave infrainguinal vasküler cerrahi uygulanmıştır.  

Bulgular: Yirmi hibrid tedavi kolunda, iliyak
arter lezyon uzunluğu 31,0 ± 7,6 mm idi. Yedi hasta TASC-II A iliyak arter
sınıfında iken, 13 hasta TASC-II B iliyak sınıfında idi.  Femoropopliteal lezyonlara göre 8 hasta TASC-II
C, 12 hasta TASC-II D. Bir hasta postoperatif dönem öldü, bir hastada greft tıkanıklığı
gelişti ve kateter yöntemi ile tedavi edildi. Takipte bir hastada iliyak arter
stent tıkanıklığı gelişti. Bir yıllık takipte ayak bileği/ kol sistolik basınç
oranı 0,91 ± 0,20 idi.

Sonuçlar: Hibrid tedavi iliyak arter ve
infrainguinal arter hastalığını içeren çoklu alt ekstremite arter hastalığında uygun
bir tekniktir. Bu teknik daha az komplikasyon oranlı açıklık oranına sahiptir. 

Anahtar Kelimeler

İliyak arter hastalığı, infrainguinal arter hastalığı, hibrid tedavi

Hybrid strategy in iliac artery disease and infrainguinal arterial occlusive disease

Öz

Aim: The treatment of peripheral arterial disease has
encompassed different therapy options. Hybrid therapy method (endovascular
treatment plus surgery) has recently been used in lower extremity arterial disease.
This study has examined hybrid therapy practice in iliac and infrainguinal
arterial disease.   

    

Materials and Methods: This study included 76 patients
with occlusive iliac artery disease and performed iliac artery endovascular
treatment from January 2010 to August 2015. While 56 patients underwent only
iliac artery stenting, 20 of 76 patients underwent additionally infrainguinal
vascular surgery (hybrid therapy). 

 

Results: In 20 hybrid patients group, iliac artery lesion
length was 31.0 ± 7.6 mm. Seven patients had TASC-II A iliac artery class,
while 13 patients had TASC-II B class. According to femoropopliteal lesions,
eight patients had TASC-II C, while 12 patients had TASC-II D.  One patient died in postoperative period.
Graft stenosis developed in one patient, which was resolved through catheter
therapy. In the one-year follow-up, in one patient, iliac stent restenosis
developed. ABI was 0.91 ± 0.20. 

Conclusion: Hybrid therapy is a feasible
option for multilevel lower extremity artery disease, including iliac artery
disease and TASC-II C or D femoropopliteal disease. This technique has
favorable patency with lower complication rates.

Anahtar Kelimeler

Iliac arterial disease, infrainguinal arterial disease, hybrid therapy

Kaynakça

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