Background： Open surgery is the preferred approach for the treatment of type D lesions according to the Trans-Atlantic Inter-Society Consensus （TASC） Ⅱ guideline, but endovascular solutions also appear to be a val...Background： Open surgery is the preferred approach for the treatment of type D lesions according to the Trans-Atlantic Inter-Society Consensus （TASC） Ⅱ guideline, but endovascular solutions also appear to be a valid option in selected patients. The study aimed to identify the risk factors ofrestenosis after open and endovascular reconstruction of symptomatic TASC Ⅱ D aortoiliac occlusive lesions （AIOLs）. Methods： Fifty-six patients （82 limbs） who underwent open repair and endovascular treatment （ET） for symptomatic TASC II D AlOEs between March 2005 and December 2012 were retrospectively reviewed. Baseline characteristics, preoperative and postoperative imaging, and operation procedure reports were reviewed and analyzed. Restenosis after revascularization was assessed by duplex ultrasound or computed tomography angiogram. Kaplan-Meier survival analysis, Log-rank test, and multivariate Cox regression were used to evaluate the relevance between risk factors and patency. Results： The mean duration of follow-up was 42.8 ± 23.5 months （ranging from 3 to 90 months）. Primary patency rates at 1-, 3-, 5-, and 7-year were 93.6%, 89.3%, 87.0%, and 70.3%, respectively. Restenosis after revascularization occurred in 1 ） limbs. Kaplan-Meier survival analysis and the Log-rank test revealed that diabetes, Rutherford classification ≥5^th and concurrent femoropopliteal TASC Ⅱ type C/D lesions were significantly related to the duration of primary patency. According to the result of Cox regression, diabetes and femoropopliteal TASC Ⅱ type C/D lesions were identified as the risk factors for restenosis after revascularization. Conclusion： This study demonstrated that diabetes and femoropopliteal TASC Ⅱ type C/D lesions are risk factors associated with restenosis after open and ET of TASC Ⅱ D AlOEs.展开更多
基金We appreciate the guidance and proof-reading of Prof. Miltiadis E Krokidis from Cambridge University Hospital.This study was supported by a grant from National Natural Science Foundation of China （No. 81370420）.
文摘Background： Open surgery is the preferred approach for the treatment of type D lesions according to the Trans-Atlantic Inter-Society Consensus （TASC） Ⅱ guideline, but endovascular solutions also appear to be a valid option in selected patients. The study aimed to identify the risk factors ofrestenosis after open and endovascular reconstruction of symptomatic TASC Ⅱ D aortoiliac occlusive lesions （AIOLs）. Methods： Fifty-six patients （82 limbs） who underwent open repair and endovascular treatment （ET） for symptomatic TASC II D AlOEs between March 2005 and December 2012 were retrospectively reviewed. Baseline characteristics, preoperative and postoperative imaging, and operation procedure reports were reviewed and analyzed. Restenosis after revascularization was assessed by duplex ultrasound or computed tomography angiogram. Kaplan-Meier survival analysis, Log-rank test, and multivariate Cox regression were used to evaluate the relevance between risk factors and patency. Results： The mean duration of follow-up was 42.8 ± 23.5 months （ranging from 3 to 90 months）. Primary patency rates at 1-, 3-, 5-, and 7-year were 93.6%, 89.3%, 87.0%, and 70.3%, respectively. Restenosis after revascularization occurred in 1 ） limbs. Kaplan-Meier survival analysis and the Log-rank test revealed that diabetes, Rutherford classification ≥5^th and concurrent femoropopliteal TASC Ⅱ type C/D lesions were significantly related to the duration of primary patency. According to the result of Cox regression, diabetes and femoropopliteal TASC Ⅱ type C/D lesions were identified as the risk factors for restenosis after revascularization. Conclusion： This study demonstrated that diabetes and femoropopliteal TASC Ⅱ type C/D lesions are risk factors associated with restenosis after open and ET of TASC Ⅱ D AlOEs.
