Effect of debulking therapy by thrombolysis in aorto-iliac artery occlusion

Objective To explore the role and clinical efficacy of catheter induced thrombolysis(CDT) debulking method in the treatment of aorto-iliac artery occlusion. Methods A total of 59 patients with aorto-iliac artery occlusion who underwent endovascular treatment between June 2013 and June 2017 were enrolled. Patients were divided into PTA group and CDT group according to the treatment methods received. The PTA group received a balloon-expandable stent placement, and the CDT group underwent thrombolytic therapy for 48 to 72 hours before angiographic evaluation and further PTA treatment. Results In the CDT group, 7 cases were still unable to place the stent after thrombolysis, and 20 patients successfully received stenting including 1-stent-placement in 16 patient and 2-stents-placement in 4. In PTA group 32 patients were treated with stents placement including 1-stent-placement in 19 patients, 2-stents in 12, 3-stents in 1. Follow-up rate was 86.3% within 1 year, the patency rate was 84.21% in the PTA group, and 76.92% in the CDT group. Conclusions CDT is effective method for occlusion of the aorto-iliac artery. TASC classification of aorto-iliac arterial occlusion degrades after CDT treatment, thus reducing the use of stenting . Key words: Arterial occlusive diseases; Stents; Catheter directed thrombolysis; Debulking treatment