Published 2018-11-20
Keywords
- aortic occlusion,
- endovascular treatment,
- Lerish syndrome
How to Cite
Copyright (c) 2018 Chernyavskiy M. A., Artyushin B. S., Chernov A. V., Chernova D. V., Zherdev N. N., Gusev A. A., Komakha B. B., Kudaev Y. Y.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Diseases of peripheral arteries are considered to be one of the main reasons for hospitalization of patients in specialized departments of vascular surgery. Patients with atherosclerotic lesions of the lower limb vessels, especially with prolonged occlusions of the aorto-iliac arterial segments, usually undergo open shunt interventions. The aim of the case is to demonstrate successful endovascular treatment of prolonged occlusion of the aorta and iliac arteries. A 54-year-old patient complained of pain in both legs while walking for more than 100 m. The history of the disease was at least 5 years. The examination revealed occlusion of the abdominal aorta at the level of the lower third, common iliac arteries. Given the anatomical features of atherosclerotic lesion, the presence of a residual aortic lumen that could be used as a guiding cult for recanalization of the occluded aorto-iliac segment and a pronounced comorbid background, it was decided to perform endovascular surgery. Stenting of the infrarenal aorta, right and left common iliac arteries yielded good angiographic and clinical results. The case report demonstrates high efficiency of endovascular treatment of the Lerish syndrome and thus reducing the risk of perioperative complications, the length of the patient's stay in the hospital. Such complex and volumetric operations can be performed only with the appropriate equipment, the presence of a hybrid operating room and coordinated work of the “vascular” team the members of which have complete mastery over open and endovascular surgery.
Received 14 May 2018. Revised 18 July 2018. Accepted 30 July 2018.
Informed consent: The patient’s informed consent to use his records for medical purposes is obtained.
Funding: The study had no sponsorship.
Conflict of interest: The authors declare no conflict of interest.
ORCID ID
B.S. Artyushin, https://orcid.org/0000-0003-2734-1641
N.N. Zherdev, https://orcid.org/0000-0003-2500-2320
References
- Национальные рекомендации по ведению пациентов с заболеваниями артерий нижних конечностей. Российский согласительный документ. Ангиология и сосудистая хирургия. 2013;19(приложение):1-67. Режим доступа: http://www.angiolsurgery.org/recommendations/2013/recommendations_LLA.pdf [National guidelines on the management of patients with arterial diseases of the lower extremities. Russian consensus document. Angiologiya i sosudistaya khirurgiya = Angiology and Vascular Surgery. 2013;19(supplement):1-67. (In Russ.) Available from: http://www.angiolsurgery.org/recommendations/2013/recommendations_LLA.pdf]
- Jongkind V., Akkersdijk G.J., Yeung K.K., Wisselink W. A systematic review of endovascular treatment of extensive aortoiliac occlusive disease. J Vasc Surg. 2010;52(5):1376-83. PMID: 20598474. http://dx.doi.org/10.1016/j.jvs.2010.04.080
- Roach A., Larion S., Ammar C., Brandt C., Ahanchi S.S., Panneton J., Dexter D. Multivariate analysis of 319 iliac stents reveals the strong impact of demographic factors and lesion severity on stent patency. J Vasc Surg. 2014;60(6):1715-1716. https://doi.org/10.1016/j.jvs.2014.09.042
- Norgren L., Hiatt W.R., Dormandy J.A., Nehler M.R., Harris K.A., Fowkes F.G.R, TASC II Working Group. Inter-Society consensus for the management of peripheral arterial disease (TASC II). Eur J Vasc Endovasc Surg. 2007;45(Suppl 1):S5-67. https://doi.org/10.1016/j.jvs.2006.12.037
- Gerhard-Herman M.D., Gornik H.L., Barrett C., Barshes N.R., Corriere M.A., Drachman D.E., Fleisher L.A., Fowkes F.G., Hamburg N.M., Kinlay S., Lookstein R., Misra S., Mureebe L., Olin J.W., Patel R.A., Regensteiner J.G., Schanzer A., Shishehbor M.H., Stewart K.J., Treat-Jacobson D., Walsh M.E. 2016 AHA/ACC Lower Extremity PAD Guideline: Executive Summary. Circulation. 2017;135(12):e686-e725. PMCID: PMC5479414, PMID: 27840332. https://doi.org/10.1161/CIR.0000000000000470
- Aboyans V., Ricco J.B., Bartelink M.E.L., Björck M., Brodmann M., Cohnert T., Collet J.P., Czerny M., De Carlo M., Debus S., Espinola-Klein C., Kahan T., Kownator S., Mazzolai L., Naylor A.R., Roffi M., Röther J., Sprynger M., Tendera M., Tepe G., Venermo M., Vlachopoulos C., Desormais I.; ESC Scientific Document Group. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39(9):763-816. PMID: 28886620. https://doi.org/10.1093/eurheartj/ehx095