3 Jahre Erfahrungen mit der intraoperativen transluminalen Angioplastie (ITA) —eine retrospektive Studie

Summary

From 1980-1982 45 transluminal angioplasties were carried out intraoperatively (ITA) in 42 patients with a mean age of 59 years for the improvement of the inflow or outflow in connection with conventional reconstructive techniques (n = 26), as angioplasty alone with surgical exposure of the arteries for introduction of the catheter material (n = 10) and after thrombectomy for elimination of the cause of occlusion (n = 9). The pelvic vascular bed was dilated eight times, the femoropopliteal vessels 30 times and a stenosed hemodialysis shunt was dilated five times. Intraoperatively, perforation occurred once in the pelvic region. Four occlusions (1 x pelvis, 3 x femoropopliteal) could not be passed with instruments. In 8.8 % immediate occlusions always occurred femoropopliteally. The causes were vessel wall dissection and calcification. One patient died for cardic reasons 14 days postoperatively. We saw one recurrent occlusion in the postoperative observation period of 9.7 months (0.5 – 28 months), also in this case in the femoral region. Since all recurrent occlusions occurred femoropopliteally in this region the indication for ITA must be made strictly. The dilatation of the pelvic arteries displays good long term results with a slight risk and should even be used intraoperatively as the treatment of first choice in the presence of appropriate morphology.

Zusammenfassung

Wir berichten über 45 intraoperative transluminale Angioplastien (ITA), die zur Erweiterung konventioneller gefäßchirurgischer Eingriffe oder als primäre ITA mit operativer Arterienfreilegung aus lokalen Gründen angewandt wurden. In 8,8 % konnte die Obstruktion mit Kathetern nicht passiert werden, in 8,8 % traten Sofortverschlüsse immer der femoropopli tealen Achse auf. Nach einem mittleren Zeitraum von 9,7 Monaten sahen wir einen Rezidivverschluß und einen Exitus aus kardialer Ursache. Aus diesen Erfahrungen und jenen der percutanen transluminalen Angioplastie kann man schließen, daß die intraoperative transluminale Angioplastie eine wertvolle Bereicherung des konventionellen angiologischen Therapiespektrums zu sein scheint.