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 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 (a1: sum of area of the systemic collateral pathways in the abdominal wall before operation, a2: sum of area of the systemic collateral pathways in the abdominal wall after operation, ar: area of lumen of the stent or artificial vessel, BSR: post- and preoperative blood supply ratio = (a2 + ar)/a1, RR: reduction rate of systemic collateral arteries after the operation = (a1-a2)/a1) 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 (a1, p = 0.301) and postoperative (a2, 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.
['Guan|Jian|J|http://orcid.org/0000-0002-7209-0346', 'Peng|Yang|Y|', 'Ouyang|Longyuan|L|', 'Li|Chang|C|', 'Fu|Wenhao|W|', 'Sun|Canhui|C|', 'Zhou|Xuhui|X|']
D019917:Blood Vessel Prosthesis Implantation D016022:Case-Control Studies D002908:Chronic Disease D003097:Collateral Circulation D000072226:Computed Tomography Angiography D005260:Female D006801:Humans D007925:Leriche Syndrome D008297:Male D008875:Middle Aged D015607:Stents D016896:Treatment Outcome D014656:Vascular Surgical Procedures
Collateral circulation Chronic Leriche syndrome Intraluminal stent implantation Surgical bypass grafting Computed tomography angiography