Current developments in interventional treatment of total terminal aortic occlusions--laser, stenting and balloon angioplasty: experience of cardiology clinic of Târgu-Mureş
Benedek, I.; Hintea, T.
Romanian Journal of Internal Medicine 43(3-4): 223-232
2005
ISSN/ISBN: 1220-4749 PMID: 16812982 Document Number: 586094
The importance of interventional procedures in the complex treatment of peripheral arterial diseases is continuously increasing. In the current practice of our clinic, association of balloon angioplasty, laser angioplasty and arterial stenting in reconstruction of iliac arteries led to superior results in the latest years, these methods 11:42 PM 11:42 PM 11:42 PM being proved as an alternative to surgical interventions. In this article, we present several cases in which current indications for laser angioplasty were extended to target occlusions located in the terminal abdominal aorta. 106 consecutive primary iliac interventions were performed on 88 patients with iliac or aortoiliac obstructive diseases, in the period September 2001 - October 2005, at the University of Medicine and Pharmacy of Târgu-Mureş, Romania, Clinic of Cardiology. Five of these patients (4 males, 1 female) presented occlusions of terminal aorta, in whom interventional treatment (peripheral transluminal angioplasty, laser angioplasty and stenting) was performed. Three cases presented total occlusion of terminal aorta, without any visualization of iliac arteries, and 2 cases presented occlusion of one aortoiliac axis, starting from terminal aorta. In all cases, complete repermeabilisation of aortoiliac axes was achieved, without complications. In all patients we recorded a significant improvement of symptomatology, and arterial Doppler showed an increase of Doppler ankle/brachial index in average from 0.4 up to 0.95. No complications have been recorded so far. Extension of classical indications of interventional treatment for balloon and laser angioplasty to occlusions located in terminal aorta is possible when the procedure is performed by an experienced team. Interventional techniques, having a superior applicability in practice, good results, low complication rates, and decreasing the hospitalization times, could be applied in the future to a larger extent, targeting also aortic occlusions.