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Endovascular Revascularization for Aortoiliac Occlusive Disease

대동맥-장골동맥 폐쇄성 질환의 혈관 내 재개통술

  • Myungsu Lee (Department of Radiology, Seoul National University Hospital)
  • 이명수 (서울대학교병원 영상의학과)
  • Received : 2021.04.26
  • Accepted : 2021.05.17
  • Published : 2021.05.01

Abstract

Peripheral arterial disease is an occlusive condition commonly involving the lower extremity vessels. When the aortoiliac region is affected by this disease, conventional management involves surgical bypass and endovascular treatment has been mainly recommended for patients with focal and simple lesions. It has been common strategy to perform endovascular treatment for selected patients with high surgical risk due to its minimally invasive nature. However, recent advances in the devices and techniques for endovascular treatment have resulted in its utilization for treating patients with various disease status and its clinical outcomes are comparable to those of conventional surgery. This review discusses the current diagnostic strategies for peripheral artery disease in the aortoiliac region, followed by the introduction of techniques and devices, and the role of endovascular treatment.

말초동맥질환은 하지혈관을 흔히 침범하는 폐쇄성 질환이다. 대동맥-장골동맥 부위에서 이를 치료하기 위한 재개통술은 전통적으로 수술적인 접근을 통한 우회술을 근간으로 하였으며, 최근에는 국소적이고 단순한 병변들을 위주로 혈관 내 접근법을 통한 치료법이 우선 권고되고 있다. 혈관 내 접근법은 그 최소침습적인 특성으로 인하여 수술의 위험성이 높은 환자에 대해서 활용하는 것이 일반적이었으나, 근래의 다양한 기법 및 기구의 발전으로 보다 다양한 질병 상태를 가진 환자에서 활용되어 수술적인 치료에 근접하는 결과가 보고되고 있다. 이 종설에서는 말초동맥 질환에 대한 진단 및 대동맥-장골동맥 부위의 혈관 내 재개통술에 활용되는 기법 및 기구들에 대해 살펴보고 그 역할에 대해 살펴보고자 한다.

Keywords

References

  1. Song P, Rudan D, Zhu Y, Fowkes FJI, Rahimi K, Fowkes FGR, et al. Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: an updated systematic review and analysis. Lancet Glob Health 2019;7:e1020-e1030
  2. DeBakey ME, Lawrie GM, Glaeser DH. Patterns of atherosclerosis and their surgical significance. Ann Surg 1985;201:115-131
  3. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG; TASC II Working Group. Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg 2007;45 Suppl S:S5-S67
  4. Society for Vascular Surgery Lower Extremity Guidelines Writing Group, Conte MS, Pomposelli FB, Clair DG, Geraghty PJ, McKinsey JF, et al. Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication. J Vasc Surg 2015; 61:2S-41S
  5. Gerhard-Herman MD, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE, et al. 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017;135:e726-e779
  6. Aboyans V, Ricco JB, Bartelink MEL, Bjorck M, Brodmann M, Cohnert T, et al. Editor's choice-2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2018;55:305-368
  7. Rutherford RB, Baker JD, Ernst C, Johnston KW, Porter JM, Ahn S, et al. Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg 1997;26:517-538
  8. Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, et al. Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association. Circulation 2012;126:2890-2909
  9. Moise MA, Alvarez-Tostado JA, Clair DG, Greenberg RK, Lyden SP, Srivastava SD, et al. Endovascular management of chronic infrarenal aortic occlusion. J Endovasc Ther 2009;16:84-92
  10. Jongkind V, Akkersdijk GJ, Yeung KK, Wisselink W. A systematic review of endovascular treatment of extensive aortoiliac occlusive disease. J Vasc Surg 2010;52:1376-1383
  11. Kokkinidis DG, Foley TR, Cotter R, Hossain P, Alvandi B, Jawaid O, et al. Acute and midterm outcomes of antegrade vs retrograde crossing strategies for endovascular treatment of iliac artery chronic total occlusions. J Endovasc Ther 2019;26:342-349
  12. Zhang H, Li X, Niu L, Feng Y, Luo X, Zhang C, et al. Effectiveness and long-term outcomes of different crossing strategies for the endovascular treatment of iliac artery chronic Total occlusions. BMC Cardiovasc Disord 2020;20:431
  13. Spinosa DJ, Leung DA, Harthun NL, Cage DL, Fritz Angle J, Hagspiel KD, et al. Simultaneous antegrade and retrograde access for subintimal recanalization of peripheral arterial occlusion. J Vasc Interv Radiol 2003; 14:1449-1454
  14. Spinosa DJ, Harthun NL, Bissonette EA, Cage D, Leung DA, Angle JF, et al. Subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) for subintimal recanalization to treat chronic critical limb ischemia. J Vasc Interv Radiol 2005;16:37-44
  15. Ikushima I, Hirai T, Ishii A, Iryo Y, Yamashita Y. Confluent two-balloon technique: an alternative method for subintimal recanalization of peripheral arterial occlusion. J Vasc Interv Radiol 2011;22:1139-1143
  16. Rogers RK, Tsai T, Casserly IP. Novel application of the "CART" technique for endovascular treatment of external iliac artery occlusions. Catheter Cardiovasc Interv 2010;75:673-678
  17. Hausegger KA, Georgieva B, Portugaller H, Tauss J, Stark G. The outback catheter: a new device for true lumen re-entry after dissection during recanalization of arterial occlusions. Cardiovasc Intervent Radiol 2004; 27:26-30
  18. Saketkhoo RR, Razavi MK, Padidar A, Kee ST, Sze DY, Dake MD. Percutaneous bypass: subintimal recanalization of peripheral occlusive disease with IVUS guided luminal re-entry. Tech Vasc Interv Radiol 2004;7:23-27
  19. Kokkinidis DG, Katsaros I, Jonnalagadda AK, Papanastasiou CA, Katamreddy A, Schizas D, et al. Use, safety and effectiveness of subintimal angioplasty and re-entry devices for the treatment of iliac artery chronic total occlusions: a systematic review of 30 studies and 1112 lesions. Cardiovasc Revasc Med 2020;21:334-341
  20. Tetteroo E, van der Graaf Y, Bosch JL, van Engelen AD, Hunink MG, Eikelboom BC, et al. Randomised comparison of primary stent placement versus primary angioplasty followed by selective stent placement in patients with iliac-artery occlusive disease. Dutch Iliac Stent Trial Study Group. Lancet 1998;351:1153-1159
  21. Klein WM, van der Graaf Y, Seegers J, Spithoven JH, Buskens E, van Baal JG, et al. Dutch iliac stent trial: long-term results in patients randomized for primary or selective stent placement. Radiology 2006;238:734-744
  22. Klein WM, van der Graaf Y, Seegers J, Moll FL, Mali WP. Long-term cardiovascular morbidity, mortality, and reintervention after endovascular treatment in patients with iliac artery disease: The Dutch Iliac Stent Trial Study. Radiology 2004;232:491-498
  23. Goode SD, Cleveland TJ, Gaines PA; STAG trial collaborators. Randomized clinical trial of stents versus angioplasty for the treatment of iliac artery occlusions (STAG trial). Br J Surg 2013;100:1148-1153
  24. Belli AM, Cumberland DC, Knox AM, Procter AE, Welsh CL. The complication rate of percutaneous peripheral balloon angioplasty. Clin Radiol 1990;41:380-383
  25. Bosch JL, Hunink MG. Meta-analysis of the results of percutaneous transluminal angioplasty and stent placement for aortoiliac occlusive disease. Radiology 1997;204:87-96
  26. Ye W, Liu CW, Ricco JB, Mani K, Zeng R, Jiang J. Early and late outcomes of percutaneous treatment of TransAtlantic Inter-Society Consensus class C and D aorto-iliac lesions. J Vasc Surg 2011;53:1728-1737
  27. Dyet JF, Watts WG, Ettles DF, Nicholson AA. Mechanical properties of metallic stents: how do these properties influence the choice of stent for specific lesions? Cardiovasc Intervent Radiol 2000;23:47-54
  28. Feldman DN, Klein AJP. Stent selection in the iliac arteries: don't fall through the ICE! JACC Cardiovasc Interv 2017;10:1705-1707
  29. Aihara H, Soga Y, Iida O, Suzuki K, Tazaki J, Shintani Y, et al. Long-term outcomes of endovascular therapy for aortoiliac bifurcation lesions in the real-AI registry. J Endovasc Ther 2014;21:25-33
  30. de Donato G, Bosiers M, Setacci F, Deloose K, Galzerano G, Verbist J, et al. 24-Month data from the BRAVISSIMO: a large-scale prospective registry on iliac stenting for TASC A & B and TASC C & D lesions. Ann Vasc Surg 2015;29:738-750
  31. Soga Y, Iida O, Kawasaki D, Yamauchi Y, Suzuki K, Hirano K, et al. Contemporary outcomes after endovascular treatment for aorto-iliac artery disease. Circ J 2012;76:2697-2704
  32. Krankenberg H, Zeller T, Ingwersen M, Schmalstieg J, Gissler HM, Nikol S, et al. Self-expanding versus balloonexpandable stents for iliac artery occlusive disease: the randomized ICE trial. JACC Cardiovasc Interv 2017;10:1694-1704
  33. Feldman DN, Armstrong EJ, Aronow HD, Banerjee S, Diaz-Sandoval LJ, Jaff MR, et al. SCAI guidelines on device selection in Aorto-Iliac arterial interventions. Catheter Cardiovasc Interv 2020;96:915-929
  34. Mwipatayi BP, Sharma S, Daneshmand A, Thomas SD, Vijayan V, Altaf N, et al. Durability of the balloon-expandable covered versus bare-metal stents in the Covered versus Balloon Expandable Stent Trial (COBEST) for the treatment of aortoiliac occlusive disease. J Vasc Surg 2016;64:83-94.e1
  35. Piazza M, Squizzato F, Dall'Antonia A, Lepidi S, Menegolo M, Grego F, et al. Editor's choice - outcomes of self expanding PTFE covered stent versus bare metal stent for chronic iliac artery occlusion in matched cohorts using propensity score modelling. Eur J Vasc Endovasc Surg 2017;54:177-185
  36. Piffaretti G, Fargion AT, Dorigo W, Pulli R, Gattuso A, Bush RL, et al. Outcomes from the multicenter Italian registry on primary endovascular treatment of Aortoiliac occlusive disease. J Endovasc Ther 2019;26:623-632
  37. Antonello M, Squizzato F, Bassini S, Porcellato L, Grego F, Piazza M. Open repair versus endovascular treatment of complex aortoiliac lesions in low risk patients. J Vasc Surg 2019;70:1155-1165.e1
  38. Palmaz JC, Encarnacion CE, Garcia OJ, Schatz RA, Rivera FJ, Laborde JC, et al. Aortic bifurcation stenosis: treatment with intravascular stents. J Vasc Interv Radiol 1991;2:319-323
  39. Sabri SS, Choudhri A, Orgera G, Arslan B, Turba UC, Harthun NL, et al. Outcomes of covered kissing stent placement compared with bare metal stent placement in the treatment of atherosclerotic occlusive disease at the aortic bifurcation. J Vasc Interv Radiol 2010;21:995-1003
  40. Greiner A, Muhlthaler H, Neuhauser B, Waldenberger P, Dessl A, Schocke MF, et al. Does stent overlap influence the patency rate of aortoiliac kissing stents? J Endovasc Ther 2005;12:696-703
  41. Sharafuddin MJ, Hoballah JJ, Kresowik TF, Sharp WJ, Golzarian J, Sun S, et al. Long-term outcome following stent reconstruction of the aortic bifurcation and the role of geometric determinants. Ann Vasc Surg 2008;22:346-357
  42. Taeymans K, Groot Jebbink E, Holewijn S, Martens JM, Versluis M, Goverde PCJM, et al. Three-year outcome of the covered endovascular reconstruction of the aortic bifurcation technique for aortoiliac occlusive disease. J Vasc Surg 2018;67:1438-1447
  43. Groot Jebbink E, Mathai V, Boersen JT, Sun C, Slump CH, Goverde PCJM, et al. Hemodynamic comparison of stent configurations used for aortoiliac occlusive disease. J Vasc Surg 2017;66:251-260.e1
  44. Groot Jebbink E, Grimme FA, Goverde PC, van Oostayen JA, Slump CH, Reijnen MM. Geometrical consequences of kissing stents and the Covered Endovascular Reconstruction of the Aortic Bifurcation configuration in an in vitro model for endovascular reconstruction of aortic bifurcation. J Vasc Surg 2015;61:1306-1311
  45. Indes JE, Pfaff MJ, Farrokhyar F, Brown H, Hashim P, Cheung K, et al. Clinical outcomes of 5358 patients undergoing direct open bypass or endovascular treatment for aortoiliac occlusive disease: a systematic review and meta-analysis. J Endovasc Ther 2013;20:443-455