Evaluation of Therapeutic Effects on Collateral Circulation in Patients with Chronic Leriche Syndrome: a Case–Control Study of Intraluminal Stent Implantation and Surgical Bypass Grafting

Purpose The aim of the study was to compare the hemodynamic effects of endoluminal and open surgical treatment of chronic Leriche syndrome using arterial collaterals on CTA as a surrogate parameter. Materials and Methods This retrospective, single-center study included 30 patients with chronic Leric...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2021-04, Vol.44 (4), p.550-557
Main Authors: Guan, Jian, Peng, Yang, Ouyang, Longyuan, Li, Chang, Fu, Wenhao, Sun, Canhui, Zhou, Xuhui
Format: Article
Language:English
Subjects:
Abdominal wall
Arterial Interventions
Arteries
Blood vessels
Cardiology
Clinical Investigation
Clinical outcomes
Complications
Grafting
Hemodynamics
Imaging
Implantation
Implants
Medicine
Medicine & Public Health
Nuclear Medicine
Parameters
Patients
Radiology
Stents
Surgical implants
Ultrasound
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Summary:Purpose The aim of the study was to compare the hemodynamic effects of endoluminal and open surgical treatment of chronic Leriche syndrome using arterial collaterals on CTA as a surrogate parameter. Materials and Methods This retrospective, single-center study included 30 patients with chronic Leriche syndrome. Fourteen patients underwent intraluminal stent implantation (endo group), and sixteen underwent surgical bypass grafting (surgical group). CTA was performed pre- and postoperatively, and a series of evaluation parameters (a 1 : sum of area of the systemic collateral pathways in the abdominal wall before operation, a 2 : sum of area of the systemic collateral pathways in the abdominal wall after operation, a r : area of lumen of the stent or artificial vessel, BSR: post- and preoperative blood supply ratio = (a 2  + a r )/a 1 , RR: reduction rate of systemic collateral arteries after the operation = (a 1 −a 2 )/a 1 ) were defined to quantitatively evaluate the hemodynamic effects of the treatments. Short-term clinical outcomes, including improvement of symptoms, postoperative complications and in-hospital stay, were also collected. Then, the effects of the two operations were compared. Results There was no significant difference in the baseline (a 1 , p  = 0.301) and postoperative (a 2 , p  = 0.802) collateral arteries, as well as BSR (p = 0.088) and RR ( p  = 0.592) between endo and surgical groups. There was also no significant difference in short-term clinical outcomes between the two groups. Conclusion Our limited series suggests that intraluminal stent implantation may not be inferior to surgical bypass grafting regarding the undifferentiated short-term clinical outcomes as well as the chosen hemodynamic surrogate parameters.
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-020-02766-1