Mehmet BOZKURT, Mohammad ALŞALALDEH, Mustafa Çağdaş ÇAYIR

İliofemoral ve femoropopliteal arterlerin tıkanıklığında endovasküler girişimler ile greft bypass cerrahisi tekniklerinin karşılaştırılması

Amaç: Periferik damar hastalığı önemli morbidite ve mortalite ile ilişkilidir. Bu çalışmada iliofemoral ve diz üstü femoropopliteal arter tıkanıklığında cerrahi baypas greftleme ile endovasküler stentleme arasında bir karşılaştırma yaparak her bir tedavi yönteminin avantaj ve dezavantajlarını ortaya çıkarmaya çalıştık. Gereç ve yöntem: Ocak 2015 ile Aralık 2020 arasında 60 hasta bu çalışmaya retrospektif olarak dahil edildi. Hastalar tedavi yöntemlerine göre iki gruba ayrıldı. Grup 1 33 hastadan oluşuyordu ve cerrahi baypas greftleme ile ameliyat edildi, grup 2 ise endovasküler girişim ile 27 hastadan oluşuyordu. Hastaların morbiditeleri, görüntüleme yöntemleri, tıkanıklığın lokalizasyonu, greft tipi ve endovasküler işlem, damar açıklığı, hastanede kalış süresi, kan transfüzyonu, revizyon ve komplikasyonlar değerlendirildi ve analiz edildi. Bulgular: Grup 1'de femoral arter tıkanıklığı (%72,7) çoğunluktayken, Grup 2'de iliak arter (%66,7) idi. Grup 1'de üç hasta, Grup 2'de balon uygulanan on dört hasta vardı. Vasküler açıklık açısından Grup 1'de 10 (%45,5) hastada greftler, Grup 2'de ise 12 (%54,5) hastada stent tıkandı. Grup 1'de on beş hastaya, Grup 2'de altı hastaya kan transfüzyonu yapıldı. Sonuç: Grup 1'de greft açıklık oranı daha yüksek, cerrahi tedavinin yeniden revaskülarizasyon oranı endovasküler tedaviye göre daha düşüktü. En yüksek greft açıklık oranı, safen venlerden sonra Dakron greftlerde görüldü. Grup 1 hastalara Grup 2 hastalarından daha fazla kan transfüzyonu yapıldı ve hastanede kalış süreleri uzatıldı.

Anahtar Kelimeler:

Cerrahi bypass greftleme, endovasküler stentleme, arter tıkanıklığı, vasküler açıklık

Comparison of graft bypass surgery and endovascular interventional techniques in iliofemoral and above knee femoropopliteal arterial occlusion

Purpose: Peripheral vascular disease is associated with significant morbidity and mortality. In this study, we made a comparison between surgical bypass grafting and endovascular stenting in iliofemoral and above-knee femoropopliteal arterial occlusion to find out the advantages and disadvantages of each treatment method. Matarials and methods: This is a retrospective study, where 60 patients had undergone endovascular and surgical interventions due to the occlusion of the iliofemoral and above-knee femoropopliteal arteries between January 2015 and December 2020. Patients were divided into two groups according to their treatment method. Group 1 contained 33 patients and was operated on with surgical bypass grafting, while group 2 contained 27 with endovascular intervention. Patients’ morbidities, imaging methods, localization of occlusion, type of grafts and endovascular procedure, vascular patency, length of hospital stay, blood transfusion, revision, and complications were evaluated and analyzed. Results: The femoral artery occlusion (72.7%) was in the majority in Group 1, while the iliac artery (66.7%) was in Group 2. There were three patients in Group 1 and 14 patients in Group 2 who had balloon administration. Regarding vascular patency, the grafts were occluded in 10 (45.5%) patients in Group 1, while stents were occluded in 12 patients (54.5%) in Group 2. Blood transfusion was performed in fifteen patients in Group 2 and six patients in Group 2. Conclusion: The graft patency rate was higher in Group 1, and the re-revascularization rate of surgical treatment was lower than endovascular treatment. The highest graft patency rate was seen in the Dacron grafts then saphenous veins. Group 1 patients received more blood transfusions and extended hospital stayment periods than Group 2 patients.

Keywords:

Surgical bypass grafting, endovascular stenting, artery occlusion, vascular patency,

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