Korean Circ J.  2022 Jul;52(7):529-540. 10.4070/kcj.2021.0390.

Long-Term Clinical Outcomes of Iliac Artery Endovascular Therapy in the Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases (K-VIS ELLA) Registry

• Roh JW
• Shin S
• Ko YG
• Son NH
• Ahn CM
• Min PK
• Lee JH
• Yoon CH
• Yu CW
• Lee SW
• Lee SR
• Choi SH
• Chae IH
• Choi D

• KMID: 2530734
• DOI: http://doi.org/10.4070/kcj.2021.0390

Abstract

Background and Objectives
Limited data are available regarding long-term clinical outcomes of iliac artery endovascular therapy (EVT) in real-world practice. This study investigated long-term outcomes according to Trans-Atlantic Inter-Society Consensus (TASC) classifications.
Methods
We analyzed data from 1,705 limbs of 1,364 patients from the retrospective cohort of the multicenter Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Disease registry. The primary endpoint was target lesion revascularization (TLR)-free survival.
Results
TASC A, B, C, and D lesions were present in 19.4%, 26.2%, 28.7%, and 25.7% of the treated limbs, respectively. The technical success rate was 96.2% and did not differ between TASC lesion types. Complications occurred in 6.8% of cases and more occurred in TASC D (11.8%). Iliac artery EVT showed a 5-year TLR-free survival of 89.2%. The TASC D group had the lowest TLR-free rate of 79.3%. TASC D (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.12–2.73; p=0.014), plain old balloon angioplasty (HR, 4.25; 95% CI, 2.03–8.88; p<0.001), current smoker (HR, 1.89; 95% CI, 1.26–2.83; p=0.002), previous bypass surgery (HR, 3.04;95% CI, 1.28–7.19; p=0.011), combined femoropopliteal treatment (HR, 4.89; 95% CI, 3.19–7.50; p<0.001), combined below the knee treatment (HR, 2.20; 95% CI, 1.25–3.89; p=0.007), and complications (HR, 1.86; 95% CI, 1.07–3.24; p=0.028) were predictors for TLR.
Conclusions
Iliac artery EVT achieved excellent technical success and 5-year TLR-free survival. TASC D showed a favorable but lower 5-year TLR-free survival rate and higher complication rate compared with other TASC groups.

Keyword

Iliac artery; Endovascular procedures; Stent; Revascularization

Figure

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  Figure 1 Study flowchart.EVT = endovascular therapy; K-VIS ELLA = Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases.

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  Figure 2 Kaplan-Meier curves for 5-year comparing the TLR-free rate (A) and clinical patency rate (B) for all patients.TLR = target lesion revascularization.

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  Figure 3 Kaplan-Meier curves for 5-year comparing the TLR-free rate (A) and clinical patency rate (B) according to the TASC classifications. The standard error did not exceed 10% up to 5 years.TASC = Trans-Atlantic Inter-Society Consensus; TLR = target lesion revascularization.

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