Efficacy and Safety of Endovascular Therapy for Aortoiliac TASC D Lesions

Suzuki, K., Mizutani, Y., Soga, Y., Iida, O., Kawasaki, D., Yamauchi, Y., Hirano, K., Koshida, R., Kamoi, D., Tazaki, J., Higashitani, M., Shintani, Y., Yamaoka, T., Okazaki, S., Suematsu, N., Tsuchiya, T., Miyashita, Y., Shinozaki, N., Takahashi, H., Inoue, N.

Angiology: The Journal of Vascular Diseases

Published online on March 15, 2016

Abstract

Background:

Although there is increasing evidence of the effectiveness of endovascular therapy for complex aortoiliac (AI) occlusive disease, it is not universally applied to TASC D lesions.

Methods:

A total of 2096 patients, 2601 limbs with AI occlusive disease, were enrolled. The lesions were categorized as TASC D (395) or TASC A-C (2206), and we compared baseline data, procedure, and follow-up result between the 2 groups.

Results:

The success rate of the procedure was significantly lower in the TASC D group (91.6% vs 99.3%, P < .01), and more procedure complications occurred in the TASC D group (11.1% vs 5.2%, P < .01). The results of a 5-year follow-up revealed no significant difference in primary patency (77.9% vs 77.1%, P = .17) and major adverse cardiovascular and limb events (MACLE; 30.5% vs 33.4%, P = .42) between the 2 groups. A multivariate analysis revealed complications and critical limb ischemia are independent predictors of MACLE in the TASC D group.

Conclusion:

The success rate of the procedure was lower in the TASC D group. Complications were more frequent in the TASC D group, and they were related to MACLE.