Outcomes From the Multicenter Italian Registry on Primary Endovascular Treatment of Aortoiliac Occlusive Disease

Piffaretti, Gabriele; Fargion, Aaron; Dorigo, Walter; Pulli, Raffaele; Gattuso, Andrea; Bush, Ruth L.; Pratesi, Carlo

doi:10.1177/1526602819863081

“…According to the TASC II guidelines, open surgery remains the gold standard of treatment for complex aortoiliac disease because it has excellent short-and longterm patency rates, which are as high as 85-92% [11,16,17]. The primary 2-year patency rate for complex and extensive lesions treated with endovascular procedures was 94% in one multicenter study, which is comparable to the outcomes of TASC A and B lesions [18]. Even the long-term outcomes of stent placement in complex aortoiliac CTOs are acceptable, such as the 5-year patency rate of 88% found in the study conducted by Ichihashi et al [19].…”

Section: Discussionmentioning

confidence: 81%

Effectiveness and long-term outcomes of different crossing strategies for the endovascular treatment of iliac artery chronic Total occlusions

Zhang

¹

,

Li

²

,

Niu

³

et al. 2020

BMC Cardiovasc Disord

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Background The iliac occlusive disease is usually treated with endovascular procedures in recent years. The effectiveness of different crossing approaches for these occlusions is not precisely known. We performed a retrospective study to explore the optimal crossing approach (antegrade versus retrograde) for iliac artery chronic total occlusions (CTOs) and to examine the long-term outcomes. Materials and methods We performed a study on 107 patients (116 iliac occlusive lesions, mean age 64.0 ± 11.1, 88 men) who underwent an iliac CTO endovascular intervention attempted with the use of both crossing strategies but were managed with one final crossing approach between August 2012 and August 2018. Baseline data, procedural characteristics, and outcomes were described. A Cox proportional hazard model and Kaplan-Meier method were developed to assess the differences in the two crossing approaches in terms of the 1-year and 5-year primary patency rates, target lesion revascularization (TLR) and major adverse limb events (MALEs). Results Common iliac artery (CIA) lesions were more likely to be crossed successfully in the retrograde direction (6.8% for antegrade vs. 20.9% for retrograde, p = 0.005), while lesions in the CIA/ external iliac artery (EIA) were more prone to be crossed successfully in the antegrade direction (58.9% for antegrade vs. 39.5% for retrograde, p = 0.016). There were no significant differences in the crossing approach for EIA lesions between the two groups. The two crossing approaches were associated with similar estimates of 1- and 5-year primary patency, TLR and MALE rates. Conclusion The antegrade approach was associated with a higher rate of successful crossing in CIA/EIA CTO lesions, while the CIA-only CTOs were more likely to be crossed successfully with the retrograde approach.

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“…According to the TASC II guidelines, open surgery remains the gold standard of treatment for complex aortoiliac disease because it has excellent short-and long-term patency rates, which are as high as 85%-92% [11,16,17]. The primary 2-year patency rate for complex and extensive lesions treated with endovascular procedures was 94% in one multicenter study, which is comparable to the outcomes of TASC A and B lesions [18]. Even the long-term outcomes of stent placement in complex aortoiliac CTOs are acceptable, such as the 5-year patency rate of 88% found in the study conducted by Ichihashi et al [19].…”

Section: Discussionmentioning

confidence: 84%

Effectiveness and Long-term Outcomes of Different Crossing Strategies for the Endovascular Treatment of Iliac Artery Chronic Total Occlusions

Zhang

¹

,

Li

²

,

Niu

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: The iliac occlusive disease is usually treated with endovascular procedures in recent years. The effectiveness of different crossing approaches for these occlusions is not precisely known. We performed a retrospective study to explore the optimal crossing approach (antegrade versus retrograde) for iliac artery chronic total occlusions (CTOs) and to examine the long-term outcomes. Materials and Methods: We performed a study on 107 patients (116 iliac occlusive lesions, mean age 64.0±11.1, 88 men) who underwent an iliac CTO endovascular intervention attempted with the use of both crossing strategies but were managed with one final crossing approach between August 2012 and August 2018. Baseline data, procedural characteristics, and outcomes were described. A Cox proportional hazard model and Kaplan-Meier method were developed to assess the differences in the two crossing approaches in terms of the 1-year and 5-year primary patency rates, target lesion revascularization (TLR ) and major adverse limb events (MALEs ). Results: Common iliac artery (CIA ) lesions were more likely to be crossed successfully in the retrograde direction (6.8% for antegrade vs. 20.9% for retrograde, p=0.005), while lesions in the CIA/ external iliac artery (EIA ) were more prone to be crossed successfully in the antegrade direction (58.9% for antegrade vs. 39.5% for retrograde, p=0.016). There were no significant differences in the crossing approach for EIA lesions between the two groups. The two crossing approaches were associated with similar estimates of 1- and 5-year primary patency, TLR and MALE rates. Conclusion: The antegrade approach was associated with a higher rate of successful crossing in CIA/EIA CTO lesions, while the CIA-only CTOs were more likely to be crossed successfully with the retrograde approach.

show abstract

“…According to the TASC II guidelines, open surgery remains the gold standard of treatment for complex aortoiliac disease because it has excellent short-and long-term patency rates, which are as high as 85%-92% [11,16,17]. The primary 2-year patency rate for complex and extensive lesions treated with endovascular procedures was 94% in one multicenter study, which is comparable to the outcomes of TASC A and B lesions [18]. Even the long-term outcomes of stent placement in complex aortoiliac CTOs are acceptable, such as the 5-year patency rate of 88% found in the study conducted by Ichihashi et al [19].…”

Section: Discussionmentioning

confidence: 84%

Effectiveness and Long-term Outcomes of Different Crossing Strategies for the Endovascular Treatment of Iliac Artery Chronic Total Occlusions

Zhang

¹

,

Li

²

,

Niu

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: The iliac occlusive disease is usually treated with endovascular procedures in recent years. The effectiveness of different crossing approaches for these occlusions is not precisely known. We performed a retrospective study to explore the optimal crossing approach (antegrade versus retrograde) for iliac artery chronic total occlusions (CTOs) and to examine the long-term outcomes. Materials and Methods: We performed a study on 107 patients (116 iliac occlusive lesions, mean age 64.0±11.1, 88 men) who underwent an iliac CTO endovascular intervention attempted with the use of both crossing strategies but were managed with one final crossing approach between August 2012 and August 2018. Baseline data, procedural characteristics, and outcomes were described. A Cox proportional hazard model and Kaplan-Meier method were developed to assess the differences in the two crossing approaches in terms of the 1-year and 5-year primary patency rates, target lesion revascularization (TLR ) and major adverse limb events (MALEs ). Results: Common iliac artery (CIA ) lesions were more likely to be crossed successfully in the retrograde direction (6.8% for antegrade vs. 20.9% for retrograde, p=0.005), while lesions in the CIA/ external iliac artery (EIA ) were more prone to be crossed successfully in the antegrade direction (58.9% for antegrade vs. 39.5% for retrograde, p=0.016). There were no significant differences in the crossing approach for EIA lesions between the two groups. The two crossing approaches were associated with similar estimates of 1- and 5-year primary patency, TLR and MALE rates. Conclusion: The antegrade approach was associated with a higher rate of successful crossing in CIA/EIA CTO lesions, while the CIA-only CTOs were more likely to be crossed successfully with the retrograde approach.

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Outcomes From the Multicenter Italian Registry on Primary Endovascular Treatment of Aortoiliac Occlusive Disease

Cited by 37 publications

References 34 publications

Effectiveness and long-term outcomes of different crossing strategies for the endovascular treatment of iliac artery chronic Total occlusions

Effectiveness and long-term outcomes of different crossing strategies for the endovascular treatment of iliac artery chronic Total occlusions

Effectiveness and Long-term Outcomes of Different Crossing Strategies for the Endovascular Treatment of Iliac Artery Chronic Total Occlusions

Effectiveness and Long-term Outcomes of Different Crossing Strategies for the Endovascular Treatment of Iliac Artery Chronic Total Occlusions

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