KẾT QUẢ SỚM ĐIỀU TRỊ TẮC HẸP ĐỘNG MẠCH TẦNG CHẬU VÀ ĐÙI MẠN TÍNH BẰNG CAN THIỆP NỘI MẠCH TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Background: Chronic lower extremity arterial occlusion often occurs at multiple levels of the arteries, and treatment typically involves multi-level interventions during a single intervention session. Therefore, we conducted this study. Objective: Evaluating early results of endovascular interventions in the treatment of chronic stenosis or occlusion of the illiac and femoral arteries during the same intervention session. Patients and methods: This is a retrospective descriptive study involving 47 patients who underwent interventions on 47 illiac and femoral arteries. The procedures were performed between June 2016 and June 2017 in the Vascular Surgery Department at Chợ Rẫy Hospital. Results: Among the 47 cases, 29.8% involved a combination of balloon angioplasty and stent placement, 70.2% were treated with balloon angioplasty alone, and there were no cases with stent placement alone. The post-intervention evaluation revealed a technical success rate of 95.7% and a hemodynamic success rate of 80.9%. The average ankle-brachial index (ABI) increased from 0.30 to 0.53 (p<0.001). The average hospital stay after the intervention was 4.1 days. One year after the follow-up, significant clinical improvement was observed, with Rutherford classification as follows: Stage 0 (31.8% compared to 0%), Stage 1 (18.2% compared to 6.3%), Stage 2 (25.0% compared to 4.3%), Stage 3 (15.9% compared to 4.3%), Stage 4 (4.5% compared to 8.5%), Stage 5 (2.3% compared to 68.1%), and Stage 6 (2.3% compared to 8.5%). Clinical success was achieved in 85.1% of cases, and hemodynamic success reached 83.0%. The average ABI increased to 0.64 (p<0.001), and the primary patency rate was 85.1%. Conclusion: Endovascular intervention in the treatment of chronic illiac and femoral artery stenosis or occlusion is a highly effective method that can be applied successfully under the conditions in Vietnam.