Sağ Kronik Total Oklüde İliak Artere Perkütan Girişim ve İliak Arter Lezyonlarına Yaklaşım
Özet
Periferik arter hastalığında (PAH), özellikle iliak arter düzeyinde kronik total oklüzyon (KTO) ile seyreden vakalar endovasküler tedavide teknik güçlük ve klinik önem taşıyan özel bir hasta grubunu oluşturmaktadır. Bu bölümde; bilinen koroner arter hastalığı ve hipertansiyonu olan, yoğun kalça ağrısı ve kladikasyo şikayetleri olan, periferik girişim amacıyla kliniğimize yatırılan 68 yaşındaki erkek hasta sunulmaktadır. Hastanın periferik arter anjiografisinde sağ ana iliak arter ostealde kronik total oklüzyon saptanmış; bidireksiyonel femoral ve brakiyal girişim kombinasyonu sonrası balon predilatasyon ve periferik balonla genişleyen stent implantasyonu ile başarılı revaskülarizasyon sağlanmıştır. Bu olgu eşliğinde iliak arter kronik total oklüzyonunun tanı ve tedavisindeki güncel yaklaşımlar, TASC II sınıflaması, endovasküler teknikler ve klinik sonuçlar literatür eşliğinde tartışılmaktadır.
In peripheral artery disease (PAD), cases with chronic total occlusion (CTO), particularly at the level of the iliac artery, constitute a special patient group that presents technical challenges and clinical significance in endovascular treatment. This section presents a 68 year-old male patient with known coronary artery disease and hypertension, admitted to our clinic for peripheral intervention due to severe hip pain and claudication symptoms. Peripheral arterial angiography revealed a chronic total occlusion at the ostium of the right common iliac artery. Successful revascularization was achieved using a combination of bidirectional femoral and brachial access, with balloon predilation and implantation of a peripheral balloon-expandable stent. In the context of this case, current approaches to the diagnosis and treatment of iliac artery chronic total occlusion, the TASC II classification, endovascular techniques, and clinical outcomes are discussed in light of the existing literature.
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