Abstract 12455: The Impact of Endovascular Therapy for TASC D lesions
Background: Recently, the application of endovascular therapy (EVT) for aortoiliac lesions has been expanded. ESC guideline mentions that endovascular-first strategy is recommended in all aortoiliacTransAtlantic Inter-Society Consensus II (TASC II) A-C lesions, however,endovascular approach for TASC D is still controversial. There were less data of EVT for TASC D lesions, so the purpose of this study was to validate the efficacy and safety of EVT for TASC D lesions.
Methods and Results: This study was sub-analysis of REAL-AI registry (retrospective multicenter analysis for aortoiliac stenting in Japan). We studied 2096 consecutive patients, 2601 lesions, and enrolled subjects were divided into TASC D and TASC A-C. 396 lesions were classified TASC D,and 2205 lesions were classified TASC A-C. Mean age showed no significant difference between two groups (TASC D 71.9 ± 8.0 vs TASC A-C 71.3 ± 7.3 years old, P=n.s.). TASC D indicated significant low ABI (0.46 ± 0.23 vs 0.64 ± 0.23, P≤0.001). More procedure complications occurred in TASC D (11.1% vs 5.2%, P≤0.001). Five years follow up results indicated that primary patency (77.8% vs 77.1%, P=0.17), MACE (a composite of all cause of death,myocardial infarction,and stroke) (23.3% and 25.3%, P=0.38) and, MACLE (MACE plus major amputation,and target vessel revascularization) (30.5% vs 33.1%, P=0.42) showed no significant differences between two groups. In TASC D, multivariate analysis indicated that the independent predictor for MACLE was only congestive heart failure.
Conclusions: EVT for TASC D lesions was efficacy and safe. There were more complications inTASC D lesions, however, primary patency, MACE, and MACLE showed no significant differences between TASC D and TASC A-C.
- © 2013 by American Heart Association, Inc.