ỨNG DỤNG PHẪU THUẬT KẾT HỢP CAN THIỆP NỘI MẠCH TRONG ĐIỀU TRỊ TẮC ĐỘNG MẠCH CHẬU MẠN TÍNH TASC II C, D

Abstract

Background: An interventional iliac artery has been widely applied in Vietnam. However, for complex pelvic floor lesions such as TASC II C, and D, the intervention alone is complicated because these lesions are associated with the femoral artery layer. Therefore, in practice, we realized that it is necessary to combine with open surgery to solve this lesion simultaneously to bring higher efficiency in the treatment process for patients with chronic lower extremity artery occlusion. That is also why we conducted a study on the effectiveness of using surgical methods combined with endovascular intervention in treating iliac artery lesions TASC II C, D. Objective: Evaluation of the results of surgery combined with endovascular intervention (Hybrid procedure) in treating chronic iliac artery occlusion TASC II C, D. Methods: Retrospective descriptive case series. Results: The study had an average age of 69.2 ± 8.2; men accounted for the majority, and TASC lesions C and D accounted for 26% and 74% of the sample, respectively. Balloon angioplasty combined with stent placement accounted for 93.5%, and endarterectomy with femoral artery angioplasty by saphenous vein accounted for 74.2%. The technical success rate is 100%, and complications are 19.5%. At 1-year follow-up, the rate of primary patency was 80.8%, the major amputation rate was 3.8%, and the mortality rate was 7.7% of the sample. Conclusion: Hybrid procedure to treat TASC II C, D lesions in patients with chronic iliac artery occlusion has significantly improved clinical symptoms, fewer complications, the high rate of techincal success and primary patency.