ĐÁNH GIÁ KẾT QUẢ SỚM ĐIỀU TRỊ TẮC HẸP ĐỘNG MẠCH CHẬU MẠN TÍNH BẰNG PHƯƠNG PHÁP CAN THIỆP NỘI MẠCH

Abstract

Research objective: Evaluate the results of early endovascular intervention in the treatment of chronic iliac artery stenosis. Determine the characteristics of arterial lesions on computed tomography angiography images that affect the results of intervention. Method: Retrospectively sampling criteria and record all data on the records in the data collection form. Collect administrative, clinical, and paraclinical information before, during the intervention, the postoperative period, and complications of the intervention. Collect information when the patient review medical records, select cases that meet re-examines 1 month and 3 months after the intervention. , 6 months, 1 year, recorded information: clinical improvement and ABI. Result: A total of 41 patients meeting the sampling criteria were included in our study. Of these, 32 patients received intervention in 1 leg, 9 patients received intervention in 2 legs at the same time, a total of 50 iliac arteries were intervened. The disease occurs in middle-aged and elderly people: 40-88, average age is 67.4 ± 11.0. The number of people gradually increased and peaked at the age of 70-79 years old, then gradually decreased. Of the total 41 patients, there were 5 women (accounting for 12%) and 36 men (accounting for 88%). Male/female ratio = 7.2/1. Smoking, lipid metabolism disorders and hypertension are the most common risk factors with rates of 90.2%, 78.1% and 63.4% respectively, especially in 5 cases. combination (12.2%) of both peripheral artery disease, coronary artery disease and cerebrovascular disease. In the study, 13 cases had cardiovascular problems (31.7%), 12 cases of lung disease (29.3%), 7 cases of chronic kidney disease (17.1%). The majority of lesions were classified as TASC A and B (66%), which are suitable lesions for endovascular treatment. The remaining are TASC C (8%) and D (28%) lesions. After intervention, 88% of legs had less pain compared to before, 96% of legs were warmer than before. After iliac artery intervention, the average ABI value was 0.66 ± 0.29 compared to pre-intervention ABI of 0.36 ± 0.31. The improvement in ABI before and after intervention was statistically significant with a paired t-test of p < 0.001. With the definition of hemodynamic success assessed by improving the ABI value compared to preoperative value > 0.10, our study group achieved 80% of successful cases. Of the 50 interventional arteries, 48 ​​cases were successful, with no complications, reaching 96%. Conclude: Immediate results evaluated immediately after endovascular intervention in the treatment of chronic iliac artery stenosis: technical success reached 100%, complication rate was 4%, hemodynamic success reached 80%. %. The method has a fairly high success rate and is quite safe when applied in Vietnam. Following up the patient after 1 year, quite positive results were obtained: head circulation rate reached 98%, clinical success reached 95%, hemodynamic success reached 94%. The effectiveness of vascular intervention is very good, similar to that in the world. Therefore, this method can be well applied in our country.