Abstract
Arteriosclerosis is the reason for iliac obliteration processes in 90% of the cases. The analysis of the clinical symptoms is necessary before an invasive treatment can be deployed. Depending on the grade of collateral circulation, patients suffer from various claudication symptoms. As distinct from Vollmar who classified iliac obliteration from type I–III, since 2000/2007 the TASC classification has been established. There are many invasive therapy options: angioplasty, surgical reconstruction and the combination of both can be chosen. The decision for an intervention in hemodynamic terms also depends on the risk evaluation, the expectations of the patient and the long-term patency rates. From January 2001 to September 2005, we performed remote iliac endarterectomy in a retrograde manner in 226 patients. In the same period, we treated 724 patients with iliac lesions. A total of 325 patients with type A and B lesions underwent an angioplasty. Only in 146 patients with bilateral processes including the infrarenal aorta was bypass surgery primarily necessary. The average age was 72.2 years, 149 men and 77 women. The symptoms were intermittent claudication in 67.8% and critical limb ischemia in 37.2%. Over a period of 48 months (3–48), we followed up 176 patients (77.8%). In addition to common criteria such as claudication distance, ankle pressure index and arterial pulse examination, we used duplex ultrasound. Restenosis occurred in 7 patients (4%), obliteration in 3 patients (1.7%).
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Gussmann, A., Kühn, J., Weise, U., Volkmann, T. (2008). Ist die retrograde Ringdesobliteration der Beckenetage unter Angiographiekontrolle Methode der ersten Wahl?. In: Gussmann, A., RÜckert, R.I. (eds) Läsionen der Becken- und Oberschenkelarterien. Berliner Gefäßchirurgische Reihe, vol 9. Steinkopff. https://doi.org/10.1007/978-3-7985-1717-2_2
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DOI: https://doi.org/10.1007/978-3-7985-1717-2_2
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