Prevention and management of complications in endovascular treatment of TASC II D type aortoiliac artery occlusion

Objective To investigate the prevention and management of complications of TASC Ⅱ D type aortoiliac occlusive disease(AIOD) endovascular treatment. Methods A retrospective analysis of the clinical data form patients in the people's hospital of Liaoning province vascular department from January 2010 to May 2017 was made, 61 TASC Ⅱ type D cases underwent endovascular treatment. Rutherford classification: eight stage 3 patients, twenty-nine stage 4 patients, fourteen stage 5 patients, ten stage 6 patients. All patients had high risk of open surgery, with indications for endovascular treatment. Accesses was carried through the femoral artery or brachial artery, and renal artery balloon protection was made by juxtarenal AIOD. Target lesions were dealt with balloon dilation and stent placement. Results 6 patients (9.83%) appeared endovascular complications and 4 patients (6.58%) appeared puncture related complications, all patients were improved after treatment. Patients were followed up for 3-60 months, the average follow-up time was 25. 6±12.4 months, 1-year, 3- year and 5-year primary patency rates were 89.83%, 81.35% and 67.79%, respectively, secondary patency rates were respectively 96.61%, 89.83%, 79.66%. During the follow-up period, 3 patients died, 1 patient underwent amputation. Conclusion The efficacy of endovascular treatment for TASC ⅡD type AIOD lesions is no doubt. Fully evaluating pathological features, reasonably selecting the accesses and scheme, eliminating the risk factors for complications are the key points to avoid postoperative complications. Key words: Aortoiliac occlusive diseases; Endovascular therapy; Complication