Ersin SARIÇAM, Yasemin SAĞLAM, Osman BETON, Bülent KAYA

İliyak arter ve infrainguinal arter tıkayıcı hastalığında hybrid strateji

Amaç: Periferik arter hastalığının tedavisi farklı tedavi seçeneklerine sahiptir. Son zamanlarda hibrid tedavi yöntemi (endovasküler tedavi artı cerrahi) alt ekstremite arter hastalığı tedavisinde kullanılmaktadır. Bu çalışmada iliyak arter ve infrainguinal periferik arter hastalığında hibrid tedavi incelenmiştir. Gereç ve Yöntemler: Bu çalışma Ocak 2010 ile Ağustos 2015 yılları arasında tıkayıcı iliyak arter hastalığı olan ve endovasküler tedavi yapılan 76 hastayı içermektedir. 56 hastaya sadece iliyak arter endovasküler tedavi uygulanırken, 20 hastaya iliyak arter endovasküler tedaviye ilave infrainguinal vasküler cerrahi uygulanmıştır. Bulgular: Yirmi hibrid tedavi kolunda, iliyak arter lezyon uzunluğu 31,0 ± 7,6 mm idi. Yedi hasta TASC-II A iliyak arter sınıfında iken, 13 hasta TASC-II B iliyak sınıfında idi. Femoropopliteal lezyonlara göre 8 hasta TASC-II C, 12 hasta TASC-II D. Bir hasta postoperatif dönem öldü, bir hastada greft tıkanıklığı gelişti ve kateter yöntemi ile tedavi edildi. Takipte bir hastada iliyak arter stent tıkanıklığı gelişti. Bir yıllık takipte ayak bileği/ kol sistolik basınç oranı 0,91 ± 0,20 idi. Sonuçlar: Hibrid tedavi iliyak arter ve infrainguinal arter hastalığını içeren çoklu alt ekstremite arter hastalığında uygun bir tekniktir. Bu teknik daha az komplikasyon oranlı açıklık oranına sahiptir.

Anahtar Kelimeler:

İliyak arter hastalığı, infrainguinal arter hastalığı, hibrid tedavi

Hybrid strategy in iliac artery disease and infrainguinal arterial occlusive disease

Aim: The treatment of peripheral arterial disease has encompassed different therapy options. Hybrid therapy method (endovascular treatment plus surgery) has recently been used in lower extremity arterial disease. This study has examined hybrid therapy practice in iliac and infrainguinal arterial disease. Materials and Methods: This study included 76 patients with occlusive iliac artery disease and performed iliac artery endovascular treatment from January 2010 to August 2015. While 56 patients underwent only iliac artery stenting, 20 of 76 patients underwent additionally infrainguinal vascular surgery (hybrid therapy). Results: In 20 hybrid patients group, iliac artery lesion length was 31.0 ± 7.6 mm. Seven patients had TASC-II A iliac artery class, while 13 patients had TASC-II B class. According to femoropopliteal lesions, eight patients had TASC-II C, while 12 patients had TASC-II D. One patient died in postoperative period. Graft stenosis developed in one patient, which was resolved through catheter therapy. In the one-year follow-up, in one patient, iliac stent restenosis developed. ABI was 0.91 ± 0.20. Conclusion: Hybrid therapy is a feasible option for multilevel lower extremity artery disease, including iliac artery disease and TASC-II C or D femoropopliteal disease. This technique has favorable patency with lower complication rates.

Keywords:

Iliac arterial disease, infrainguinal arterial disease, hybrid therapy,

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