Objective:To investigate the clinical outcomes of endovascular treatment of complex aortoiliac artery occlusion (AIOD).Method:The data of 71 AIOD patients admitted to the Department of Vascular Surgery of Fuwai Hospital from January 2016 to December 2022 were retrospectively analyzed. All of them, 66 males and 5 females with a age of (64.4±8.9) years(range: 39-38 years), were identified as grade D in the second edition of Trans-Alantic Inter-Society Consensus (TASC-II). All patients underwent aortoiliac artery endovascular intervention and their follow-up results were obtained. Univariate and multivariate logistic regression analysis was applied to screen the risk factors affecting post-operative patency rate, and Kaplan-Meier curve was used to analyze the survival rates.Results:Sixty patients received first-stage stent implantation and 11 patients received second-stage stent implantation after catheter-directed thrombolysis with a technical success rate of 100%. Among them, 51 patients received kissing stent implantation,7 bare metal stent implantation,2 iliac artery stent implantation combined with fermoral endarerectomy, and 11 covered stent combined with bare metal stent implantation. The average preoperative ankle-brachial index(ABI) was 0.53 ± 0.26, and the postoperative ABI was 0.92 ± 0.21, which was significantly improved ( t=27.305, P<0.01). Among the 71 patients, acute stent thrombosis occurred in 2 cases, puncture complications in 3 cases and external iliac artery ruputure in 1 case. A number of 65 cases were followed (91.5%). The median follow-up time was (42.5±21.8) months, during which in-stent restenosis occurred in 12 cases and 1 patient underwent above-knee amputation 1 month after the surgery. The primary patency rate was 81.5% (53/65), the secondary patency rate was 100% and the limb salvage rate was 99% (64/65). Multivariate logistic regression analysis showed that severe calcification was an independent factor affecting postoperative patency rate ( OR=9.56,95% CI:1.76~51.77, P=0.01). Kaplan-Meier survival curve showed that the patency rate of patients with severe calcification was lower than that of patients without severe calcification, and the difference was statistically significant (Log-rank χ2=10.038, P=0.01). Conclusion:Endovascular treatment of complex AIOD has a high long-term patency rate. Long-term patency rate can be affected by severe calcification.

目的 分析心上型完全性肺静脉异位引流的手术治疗结果.方法 回顾性分析2014～2019年在本中心行外科手术治疗的98例心上型完全性肺静脉异位引流患者的临床资料,其中男64例、女34例,中位手术年龄3.0(1.5,7.0)个月,中位体重5.0 (4.0,6.0) kg.术前肺静脉梗阻23例(23.5％).传统手术技术治疗92例(93.9％),Sutureless技术治疗6例(6.1％).采用Cox回归模型分析数据.结果 中位随访时间26.50 (5.75,44.25)个月.术后死亡9例(9.2％);低体重(P=0.013)、体外循环时间长(P=0.007)为术后死亡的相关因素.8例出现术后肺静脉梗阻(8.2％);低体重(P=0.042)及体外循环时间长(P=0.002)为术后肺静脉梗阻的相关因素.结论 本中心外科手术治疗心上型完全性肺静脉异位引流取得较满意的近中期结果.合并低体重、体外循环时间长的病例预后较差.