Role of Endovascular Intervention in Iliac Artery Disease TASC C and D Classification

Abstract

Abstract Background: For more than forty years, endarterectomy and bypass grafting have been the primary means of surgically revascularizing peripheral vessels threatened by atherosclerotic disease. However, with today's endovascular technology, stenosis and occlusions in nearly every circulatory system can he approached intraluminally with balloon dilatation and intravascular stents. Aim of Study: Was to evaluate the technical success rates, primary patency, limb salvage, patient survival and compli-cations for TASC C and D iliac lesions treated by endovascular procedure. Additionally, the influence of the access site and the clinical outcomes were analyzed. Patients and Methods: Between 2017 and 2019, data from 40 consecutive patients at Al-Zahraa University Hospital and Damanhor Teaching Hospital with 47 chronic iliac artery stenosis and/or occlusion who were treated with EVT were reviewed. Results: The procedure time was longer for TASC D lesions than for TASC C lesions (180.43±45.97 vs. 131.69± 37.49: p=0.001). There were two post-operative deaths in the TASC D lesion group, with the cause being one myocardial infarction and one post-operative hospital acquired pneumonia. The total perioperative complication rate was higher in the TASC D lesions than in TASC C lesions [four (10%) vs. zero; p=0.011]. Corresponding 2-year primary patency rates were 100% in TASC C lesions, 71.4% in TASC D lesions and for all cases were 87.5%. Conclusion: This study demonstrated that the outcomes of EVT for TASC C and D aorto-iliac lesions were acceptable, with better technical success in TASC C lesions than in TASC D lesions. Furthermore, the 2-year patency rate for both TASC C and TASC D lesions was acceptable, and brachial access was useful for complex anatomy.