[Endovascular contra open surgical treatment of symptom generating atherosclerotic lesions of the external iliac artery]
Mellander S, Daxberg E-L, Jivegård L, Rezk F, Sakinis A, Svanberg T, Sjövall H
Record ID 32013000126
Authors' objectives: Sclerosis of the external iliac artery (a.iliaca externa) is relatively common in atherosclerotic disease. In severe cases this can lead to ulceration, necrosis, and in the worst case necessitate leg amputation. Patients usually have symptoms of exertion-related pain in the leg ("intermittent claudicatio"). This condition is usually treated surgically, either by open surgery in which the replacement of the affected vessel with a vascular prosthesis, or with endovascular technique where access is gained via another artery, the constricted segment is dilated and usually a self-expanding net, a so called endovascular stent, is introduced to keep the vessel open. The endovascular technique, which is much less invasive and leads to shorter hospital stays, has gradually established itself as a routine method and the use of open surgery has been greatly reduced. This technology transfer is based on a relatively weak scientific evidence and there is an impression among vascular surgeons that it may lead to a lower percentage of patent vessels at follow-up (reduced primary patency). The aim of the HTA analysis is to clarify the scientific basis for the replacement of open surgery with endovascular techniques in patients with symptomatic atherosclerotic disease of the external iliac artery.
Authors' recommendations: Endovascular treatment may have a lower percentage of open standing reconstructions after one to five years compared to open surgical treatment. The scientific evidence for this conclusion is insufficient (GRADE + ). For the other outcome measures included in our PICO, there are no comparative studies containing separate results for lesions of the external iliac artery.
Project Status: Completed
Year Published: 2012
URL for published report: http://www.sahlgrenska.se/upload/SU/HTA-centrum/HTA-rapporter/HTA-rapport%20Stenoser%20i%20iliaca%202012-08-29%20%20inkl%20bil%20till%20publicering.pdf
URL for additional information: http://www.sahlgrenska.se/sv/SU/Forskning/HTA-centrum/Hogerkolumn-undersidor/Publicerade-rapporter/
English language abstract: An English language summary is available
Publication Type: Not Assigned
Organisation Name: The Regional Health Technology Assessment Centre
Contact Address: The Regional Health Technology Assessment Centre, Region Vastra Gotaland, HTA-centrum, Roda Straket 8, Sahlgrenska Universitetssjukhuset, 413 45 GOTHENBORG, Sweden
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Copyright: The Regional Health Technology Assessment Centre (HTA-centrum), Region Vastra Gotaland
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