The aim of the study is to evaluate the efficacy of percutaneous transluminal angioplasty in reduction of the lower limb ischemia and to investigate the influence of this procedure on the lower limb salvage rate. The introduction defines the objectives and tasks of the study, includes a literature review, a summary of the main problems related to the theme. A separate chapter describes the research methodology. The study analysed the treatment results of 146 patients who underwent the iliac artery percutaneous transluminal angioplasty. The following PTA efficacy criteria were determined - the increase of ankle-brachial index and the decrease of ischemia according to Fontaine stages of limb ischemia. It was also found that the substantial PTA effect of the iliac artery and the need for additional interventions become evident during the early postoperative period (1–7 days after PTA), and the effect of angioplasty decreases gradually during one year follow-up after the procedure. To arrest the progression of ischemia an additional endovascular procedure or an open surgery of femoral, popliteal and the crural arteries is necessary. The majority of these operations or procedures are reconstructive operations of the femoral, popliteal and the crural arteries. The effectiveness of the iliac artery PTA depends on the stage of lower limb ischemia. The need of an additional intervention is determined by the nature of lesion of the femoral arteries and the increase in ankle-brachial... [to full text] / Tyrimo tikslas – nustatyti klubo arterijų perkutaninės transliuminalinės angioplastikos veiksmingumą mažinant apatinių galūnių išemiją ir ištirti, kokios įtakos ši gydomoji procedūra turi galūnių amputacijos dažniui. Įvade išdėstomi tyrimo tikslai bei uždaviniai, pateikiama literatūros apžvalga, kurioje apibendrinamos pagrindinės su nagrinėjama tema susijusios problemos. Atskirame skyriuje aprašyta tyrimo metodika. Disertacijoje išnagrinėti 146 pacientų, kuriems atlikta klubo arterijų perkutaninė transliuminalinė angioplastika, gydymo rezultatai. Nustatyta, kad kriterijai angioplastikos veiksmingumui įvertinti – kulkšnies-žasto indekso pokytis, išemijos sumažėjimas pagal Fontaine’o galūnės išemijos stadijas. Taip pat nustatyta, kad klubo arterijos PTA pakankamas efektas ir papildomų intervencijų poreikis daugiausia išryškėja ankstyvuoju pooperaciniu laikotarpiu (iki 7 dienų po PTA), o PTA rezultatai laipsniškai blogėja per vienerius metus. Išemijos progresavimui sustabdyti reikalinga šlaunies, pakinklio ir blauzdos arterijų papildoma endovaskulinė arba atviroji operacija, dažniausiai – rekonstrukcinės arterijų operacija. Klubo arterijų angioplastikos veiksmingumas priklauso nuo išemijos stadijos. Papildomos intervencijos poreikį po PTA lemia šlaunies arterijų pažeidimo pobūdis, kulkšnies-žasto indekso pokytis mažiau negu 0,15. Bendras pacientų sergamumas kitomis ligomis pakankamos angioplastikos ir papildomų intervencijų grupėje buvo vienodas. Iš tirtų periferinių arterijų... [toliau žr. visą tekstą]

Objetivo: Avaliar se a administração sistêmica de cilostazol reduz a hiperplasia neointimal nas artérias ilíacas de suínos submetidas a angioplastia com cateter balão. Métodos: O trabalho foi desenvolvido na Unidade de Experimentação Animal do Hospital de Clínicas de Porto Alegre. Vinte suínos foram submetidos a angioplastia com cateter balão 6 x 40 mm na artéria ilíaca comum direita, guiada por ultrassonografia com Doppler. Os animais foram randomizados em dois grupos: grupo 1 (n = 10), no qual foi administrado cilostazol 50 mg em duas doses diárias, e grupo 2 (n = 10), considerado controle. Após 30 dias, os animais foram sacrificados, e as artérias ilíacas preparadas para análise histológica. Os cortes histológicos foram digitalizados e analisados por morfometria digital. A análise estatística foi realizada com o teste t de Student e o de Mann-Whitney. Resultados: Comparando as artérias ilíacas submetidas a angioplastia com as não submetidas a angioplastia, houve hiperplasia neointimal significativa (0,228 versus 0,119 mm2; p = 0,0001). Nas artérias submetidas a angioplastia, não houve diferença entre o grupo 1 (cilostazol) e o grupo 2 (controle) na área do lúmen (2,277 versus 2,575 mm2; p = 0,08), área da íntima (0,219 versus 0,237 mm2; p = 0,64), área da média (2,262 versus 2,393 mm2; p = 0,53) e no percentual de obstrução neointimal (8,857 versus 9,257 %; p = 0,82). Conclusão: O uso de cilostazol 50 mg em duas doses diárias não reduziu a hiperplasia neointimal em artérias ilíacas de suínos submetidas a angioplastia com cateter balão. / Objective: To evaluate whether systemic administration of cilostazol reduces neointimal hyperplasia in the iliac arteries of pigs after balloon angioplasty. Methods: This study was conducted in the Experimental Animal Unit of Hospital de Clínicas de Porto Alegre, Brazil. Twenty pigs underwent angioplasty of the right common iliac artery under Doppler ultrasound guidance using 6x40-mm balloon catheters. The animals were randomized to one of two groups: group 1 (n = 10) received 50 mg cilostazol in two doses a day; and group 2 (n = 10) was the control group. After 30 days, the animals were killed and their iliac arteries were prepared for histological analysis. Histological images were digitalized and analyzed using digital morphometry. The Student t and the Mann-Whitney tests were used for statistical analyses. Results: Iliac arteries that underwent angioplasty had significantly more neointimal hyperplasia than those with no angioplasty (0.228 versus 0.119 mm2; p = 0.0001) Group 1 (cilostazol) and 2 (control) had no significant differences in lumen (2.277 versus 2.575 mm2; p = 0.08), intima (0.219 versus 0.237 mm2; p = 0.64) or media (2.262 versus 2.393 mm2; p = 0.53) area, or in percentage of neointimal obstruction (8.857 versus 9.257 %; p = 0.82). Conclusion: The use of 50 mg cilostazol in two doses a day did not reduce neointimal hyperplasia in iliac arteries of pigs that underwent balloon angioplasty.

Submitted by NADIA FAGUNDES GARCIA null (nadia.garcia@usp.br) on 2016-04-26T14:05:01Z No. of bitstreams: 1 Dissertação_Nádia_final.pdf: 1655190 bytes, checksum: 3ec5b191317646b34cbfef983fcdf111 (MD5) / Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2016-04-29T15:08:25Z (GMT) No. of bitstreams: 1 garcia_nf_me_rcla.pdf: 1655190 bytes, checksum: 3ec5b191317646b34cbfef983fcdf111 (MD5) / Made available in DSpace on 2016-04-29T15:08:25Z (GMT). No. of bitstreams: 1 garcia_nf_me_rcla.pdf: 1655190 bytes, checksum: 3ec5b191317646b34cbfef983fcdf111 (MD5) Previous issue date: 2016-03-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A inatividade física e as dislipidemias são considerados fatores de risco para a gênese das doenças cardiovasculares. Estudos em animais mostram que o consumo de dieta contendo alto teor de lipídios leva à diminuição da resposta relaxante dependente do endotélio, o que pode ser prevenido pela realização de exercício físico. Entretanto, a maioria dos estudos investigou os efeitos do exercício físico em artérias de maior calibre e em modelos de dislipidemia induzida por dieta. Há escassez de estudos que avaliam os efeitos do exercício físico em artéria de menor calibre e, principalmente, em modelo que mimetiza a hipercolesterolemia familiar (HF). Portanto, o objetivo do presente estudo foi avaliar o efeito do treinamento físico aeróbio de moderada intensidade na reatividade vascular da artéria ilíaca em camundongos knockout para o receptor de LDL alimentados com dieta hiperlipídica. Foram utilizados camundongos wild type e knockout para o receptor de LDL (LDLR-/-) divididos em quatro grupos experimentais: wild type sedentário (WT), wild type treinado (WT/Ex), knockout sedentário (KO) e knockout treinado (KO/Ex). Os grupos WT foram alimentados com ração balanceada e os grupos KO com dieta hiperlipídica (38% lipídios). Os grupos WT/Ex e KO/Ex realizaram corrida em esteira (60-70%Vmax, 5 dias/semana, 60 min) durante oito semanas. A reatividade vascular em artéria ilíaca foi verificada através de curvas concentração-resposta a acetilcolina (ACh), nitroprussiato de sódio (SNP), fenilefrina (PHE) e ao análogo do tromboxano A2 (U46619). A determinação da produção de óxido nítrico (NO) foi realizada pela análise de fluorescência ao 4,5-diaminofluoresceína (DAF-2) e a produção de ânion superóxido pela análise da fluorescência derivada da oxidação da dihidroetidina (DHE). Foi quantificada a glicose, o colesterol total e os triglicerídeos sanguíneos. O grupo KO aumentou em 640% o ganho de peso corporal, 510% a gordura epididimal, 35% a glicose, 180% o colesterol total e 99% os triglicerídeos comparado ao grupo WT e o treinamento físico aeróbio foi eficaz em prevenir o ganho de peso e a gordura epididimal no grupo KO/Ex (167% e 121%, respectivamente). Nenhuma alteração foi verificada na glicose, colesterol total e triglicerídeos no soro. O relaxamento máximo induzido por ACh foi reduzido em 24% no grupo KO comparado ao grupo WT, sendo esta resposta normalizada no grupo KO/Ex, sem alteração na potência. A resposta máxima a PHE foi 65% maior, e resposta da potência foi 3 vezes maior na artéria ilíaca de animais do grupo KO comparado ao grupo WT. Nenhuma alteração na resposta foi encontrada aos agentes SNP e U46619. A produção de NO foi 47% menor no grupo KO comparado ao WT e a produção de espécies reativas de oxigênio (ERO) foi 48% maior no grupo KO comparado ao grupo WT. O treinamento físico preveniu o aumento na produção de ERO no grupo KO/Ex. Em conclusão, o exercício físico aeróbio, realizado por oito semanas, preveniu a disfunção endotelial na artéria ilíaca de camundongos LDLR-/- alimentados com dieta hiperlipídica. Este achado pode estar relacionado à menor produção de ERO, o que aumentaria a biodisponibilidade do NO. / Physical inactivity and dyslipidemia are considered risk factors for cardiovascular disease. A decrease in endothelium-dependent relaxation response, which can be prevented by physical exercise, had been showing in animals fed with high fat diet. However, most studies investigated the effects of physical exercise on large-caliber arteries using models of diet induced dyslipidemia. There are few studies that evaluate the effects of physical exercise in small-caliber artery and, mainly, in a model that mimics familial hypercholesterolemia (FH). Therefore, the aim of this study was to evaluate the effect of moderate intensity exercise training on vascular reactivity of iliac artery in FH model using mice lacking LDL receptor. Wild type and knockout mice (LDLR-/-) were divided into four groups: sedentary control (WT), trained control (WT/Ex), sedentary knockout (KO) and trained knockout (KO/Ex). Control groups were fed with standard chow and knockout groups with high fat diet. Trained groups ran on a treadmill (60-70% Vmax, 60 min, 5 days/week for 8 weeks). Concentration-response curves to acetylcholine (ACh), sodium nitroprusside (SNP), phenylephrine (PHE) and thromboxane A2 analogue (U46619) were done in iliac artery rings. Arterial production of nitric oxide and oxygen reactive species formation were assessed using fluorescence analysis (DAF-2 and DHE). Serum concentration of glucose, total cholesterol and triglyceride were determined using commercial kits. After eight weeks, the KO group had higher body weight gain (around 640%), epididymal fat (510%), glucose (35%), total cholesterol (180%) and triglycerides (99%) compared with WT group. Exercise training was effective to prevent body weight and epididymal fat gain in KO/Ex group (less 167% and 121%, respectively). No changes were observed in glucose, total cholesterol and triglycerides concentration. KO animals had lower maximal response evoked by ACh (about 24%) and higher maximal response to PHE (about 65%) compared with WT group. Exercise training prevented these alterations since KO/Ex group had vascular response similar to WT and WT/Ex groups. Endothelial dysfunction observed in KO group could be related to the reduced production of NO (about 47%) and the increased formation of oxygen reactive species (about 48%). These features were partially prevented by exercise training, KO/Ex group had lower formation of oxygen species and a slight higher NO prodution compared with KO group. In conclusion, aerobic exercise training carried out for eight weeks, prevented endothelial dysfunction in iliac artery from LDLR-/- mice fed with high fat diet. This finding could be related to the lower formation of reactive oxygen species in situ that increases the NO bioavailability.

Objetivo: Avaliar se a administração sistêmica de cilostazol reduz a hiperplasia neointimal nas artérias ilíacas de suínos submetidas a angioplastia com cateter balão. Métodos: O trabalho foi desenvolvido na Unidade de Experimentação Animal do Hospital de Clínicas de Porto Alegre. Vinte suínos foram submetidos a angioplastia com cateter balão 6 x 40 mm na artéria ilíaca comum direita, guiada por ultrassonografia com Doppler. Os animais foram randomizados em dois grupos: grupo 1 (n = 10), no qual foi administrado cilostazol 50 mg em duas doses diárias, e grupo 2 (n = 10), considerado controle. Após 30 dias, os animais foram sacrificados, e as artérias ilíacas preparadas para análise histológica. Os cortes histológicos foram digitalizados e analisados por morfometria digital. A análise estatística foi realizada com o teste t de Student e o de Mann-Whitney. Resultados: Comparando as artérias ilíacas submetidas a angioplastia com as não submetidas a angioplastia, houve hiperplasia neointimal significativa (0,228 versus 0,119 mm2; p = 0,0001). Nas artérias submetidas a angioplastia, não houve diferença entre o grupo 1 (cilostazol) e o grupo 2 (controle) na área do lúmen (2,277 versus 2,575 mm2; p = 0,08), área da íntima (0,219 versus 0,237 mm2; p = 0,64), área da média (2,262 versus 2,393 mm2; p = 0,53) e no percentual de obstrução neointimal (8,857 versus 9,257 %; p = 0,82). Conclusão: O uso de cilostazol 50 mg em duas doses diárias não reduziu a hiperplasia neointimal em artérias ilíacas de suínos submetidas a angioplastia com cateter balão. / Objective: To evaluate whether systemic administration of cilostazol reduces neointimal hyperplasia in the iliac arteries of pigs after balloon angioplasty. Methods: This study was conducted in the Experimental Animal Unit of Hospital de Clínicas de Porto Alegre, Brazil. Twenty pigs underwent angioplasty of the right common iliac artery under Doppler ultrasound guidance using 6x40-mm balloon catheters. The animals were randomized to one of two groups: group 1 (n = 10) received 50 mg cilostazol in two doses a day; and group 2 (n = 10) was the control group. After 30 days, the animals were killed and their iliac arteries were prepared for histological analysis. Histological images were digitalized and analyzed using digital morphometry. The Student t and the Mann-Whitney tests were used for statistical analyses. Results: Iliac arteries that underwent angioplasty had significantly more neointimal hyperplasia than those with no angioplasty (0.228 versus 0.119 mm2; p = 0.0001) Group 1 (cilostazol) and 2 (control) had no significant differences in lumen (2.277 versus 2.575 mm2; p = 0.08), intima (0.219 versus 0.237 mm2; p = 0.64) or media (2.262 versus 2.393 mm2; p = 0.53) area, or in percentage of neointimal obstruction (8.857 versus 9.257 %; p = 0.82). Conclusion: The use of 50 mg cilostazol in two doses a day did not reduce neointimal hyperplasia in iliac arteries of pigs that underwent balloon angioplasty.

Objetivo: Avaliar se a administração sistêmica de cilostazol reduz a hiperplasia neointimal nas artérias ilíacas de suínos submetidas a angioplastia com cateter balão. Métodos: O trabalho foi desenvolvido na Unidade de Experimentação Animal do Hospital de Clínicas de Porto Alegre. Vinte suínos foram submetidos a angioplastia com cateter balão 6 x 40 mm na artéria ilíaca comum direita, guiada por ultrassonografia com Doppler. Os animais foram randomizados em dois grupos: grupo 1 (n = 10), no qual foi administrado cilostazol 50 mg em duas doses diárias, e grupo 2 (n = 10), considerado controle. Após 30 dias, os animais foram sacrificados, e as artérias ilíacas preparadas para análise histológica. Os cortes histológicos foram digitalizados e analisados por morfometria digital. A análise estatística foi realizada com o teste t de Student e o de Mann-Whitney. Resultados: Comparando as artérias ilíacas submetidas a angioplastia com as não submetidas a angioplastia, houve hiperplasia neointimal significativa (0,228 versus 0,119 mm2; p = 0,0001). Nas artérias submetidas a angioplastia, não houve diferença entre o grupo 1 (cilostazol) e o grupo 2 (controle) na área do lúmen (2,277 versus 2,575 mm2; p = 0,08), área da íntima (0,219 versus 0,237 mm2; p = 0,64), área da média (2,262 versus 2,393 mm2; p = 0,53) e no percentual de obstrução neointimal (8,857 versus 9,257 %; p = 0,82). Conclusão: O uso de cilostazol 50 mg em duas doses diárias não reduziu a hiperplasia neointimal em artérias ilíacas de suínos submetidas a angioplastia com cateter balão. / Objective: To evaluate whether systemic administration of cilostazol reduces neointimal hyperplasia in the iliac arteries of pigs after balloon angioplasty. Methods: This study was conducted in the Experimental Animal Unit of Hospital de Clínicas de Porto Alegre, Brazil. Twenty pigs underwent angioplasty of the right common iliac artery under Doppler ultrasound guidance using 6x40-mm balloon catheters. The animals were randomized to one of two groups: group 1 (n = 10) received 50 mg cilostazol in two doses a day; and group 2 (n = 10) was the control group. After 30 days, the animals were killed and their iliac arteries were prepared for histological analysis. Histological images were digitalized and analyzed using digital morphometry. The Student t and the Mann-Whitney tests were used for statistical analyses. Results: Iliac arteries that underwent angioplasty had significantly more neointimal hyperplasia than those with no angioplasty (0.228 versus 0.119 mm2; p = 0.0001) Group 1 (cilostazol) and 2 (control) had no significant differences in lumen (2.277 versus 2.575 mm2; p = 0.08), intima (0.219 versus 0.237 mm2; p = 0.64) or media (2.262 versus 2.393 mm2; p = 0.53) area, or in percentage of neointimal obstruction (8.857 versus 9.257 %; p = 0.82). Conclusion: The use of 50 mg cilostazol in two doses a day did not reduce neointimal hyperplasia in iliac arteries of pigs that underwent balloon angioplasty.

The goal of this project was to determine whether i) fused deposition modeling could be employed to manufacture molds for vascular constructs, ii) whether vascular constructs could be created from these molds, and iii) to verify practical equivalence between observed fluid velocities. Dye tracking was to be employed to characterize fluid velocity profiles through the in vitro vascular constructs, including a half-vessel model and a full vessel model of an iliac artery aneurysm. A PDMS half-vessel construct was manufactured, and the movement of dye through the construct was tracked by a cellphone camera. Thresholds were applied to each video in HSB or YUV mode in ImageJ, and analyzed to determine the velocity of the fluid through the construct. COMSOL simulations of the half-vessel were conducted for comparison to the empirical observations. Plots describing the flow velocities along the maximum streamline path length were generated, and a one sample t-test was conducted at a 5% significance level to determine whether there was a significant difference between velocity values obtained by dye tracking and the COMSOL simulations. It was determined that the empirical dye tracking trials failed to demonstrate agreement between the measured and predicted flow rates. A full vessel construct was not completed due to unforeseen time constraints. Dye tracking was not determined to be reliable as a means of measuring the maximum velocity of fluid. Discrepancies between the empirical observations and the COMSOL simulation are discussed. The discrepancy was attributed to limitations in the experimental protocol; low frame rate, poor control over lighting conditions, and the subjectivity involved in image processing. Methods of improving upon the manufacturing and experimental protocols used for the half-vessel are proposed for future work, such as improving control over lighting conditions, choosing a camera with a higher frame rate, constructing a more stable fixture, exploring PIV. Additionally, the technical problems leading to the failure to complete the full vessel model are discussed, and changes in the manufacturing process are proposed to allow dissolution or removal of the aneurysm model.

<p>In contrast-enhanced magnetic resonance angiography (CE-MRA),vascular signal is produced by the acquisition of a T1-weighted magnetic resonance imaging scan while the presence of a contrast agent induces a low T1 in blood. In this thesis,CE-MRA of the aortoiliac arteries was evaluated.Different contrast agents and techniques for synchronisation of the scan with the contrast bolus passage were assessed.</p><p>In 30 patients with clinically suspected iliac artery stenoses,contrast-enhanced magnetic resonance angiography was compared with duplex ultrasound scanning and digital subtraction x-ray angiography (DSA),with intraarterial pressure measurements as reference method. No statistically significant differences in sensitivity or specificity were observed between the techniques regarding the detection of hemodynamically significant iliac stenoses. The use of multiplanar reformats and source images in the MRA examinations was of value for the differentiation between high-grade stenoses and occlusions. With DSA as reference method, MRA had significantly higher sensitivity and specificity than duplex for the detection of ≥50% stenoses.</p><p>In fourteen patients examined with iliac artery MRA, differences in contrast arrival time of up to 7 s was observed between the aorta and the common femoral artery.A dual-station timing technique adjusting for this difference was found feasible. Compared with a fluoroscopically triggered technique (n=13),which is used in clinical rotine, the dual-station technique was more reliable for the visualisation of distal vessels.</p><p>In a clinical phase II study comparing different doses of t he contrast agent gadobenate dimeglumine for the enhancement of iliac artery MRA, a significant improvement in subjective diagnostic quality compared with time-of-flight MRA was found at all doses from 0.025 mmol/kg.An increasing trend with dose was observed up to a dose level of 0.05-0.1 mmol/kg.</p><p>In a phase I clinical study on the intravascular, iron oxide contrast agent NC100150 Injection, a positive dose response was observed for abdominal vascular enhancement, with the highest contrast-to-noise ratio observed at 4.0 mg Fe/kg bw at 1.5 T and at 2.5-4 mg Fe/kg bw at 0.5 T.At 1.5 T higher R2*values were calculated for the aorta than for the IVC.</p>

In contrast-enhanced magnetic resonance angiography (CE-MRA),vascular signal is produced by the acquisition of a T1-weighted magnetic resonance imaging scan while the presence of a contrast agent induces a low T1 in blood. In this thesis,CE-MRA of the aortoiliac arteries was evaluated.Different contrast agents and techniques for synchronisation of the scan with the contrast bolus passage were assessed. In 30 patients with clinically suspected iliac artery stenoses,contrast-enhanced magnetic resonance angiography was compared with duplex ultrasound scanning and digital subtraction x-ray angiography (DSA),with intraarterial pressure measurements as reference method. No statistically significant differences in sensitivity or specificity were observed between the techniques regarding the detection of hemodynamically significant iliac stenoses. The use of multiplanar reformats and source images in the MRA examinations was of value for the differentiation between high-grade stenoses and occlusions. With DSA as reference method, MRA had significantly higher sensitivity and specificity than duplex for the detection of ≥50% stenoses. In fourteen patients examined with iliac artery MRA, differences in contrast arrival time of up to 7 s was observed between the aorta and the common femoral artery.A dual-station timing technique adjusting for this difference was found feasible. Compared with a fluoroscopically triggered technique (n=13),which is used in clinical rotine, the dual-station technique was more reliable for the visualisation of distal vessels. In a clinical phase II study comparing different doses of t he contrast agent gadobenate dimeglumine for the enhancement of iliac artery MRA, a significant improvement in subjective diagnostic quality compared with time-of-flight MRA was found at all doses from 0.025 mmol/kg.An increasing trend with dose was observed up to a dose level of 0.05-0.1 mmol/kg. In a phase I clinical study on the intravascular, iron oxide contrast agent NC100150 Injection, a positive dose response was observed for abdominal vascular enhancement, with the highest contrast-to-noise ratio observed at 4.0 mg Fe/kg bw at 1.5 T and at 2.5-4 mg Fe/kg bw at 0.5 T.At 1.5 T higher R2*values were calculated for the aorta than for the IVC.

This master thesis analyses stress and strain of iliac artery with atheroma. Model of artery is created as 2D and symmetric about the y-axis. The first part of the thesis deals with a research, which includes obtaining information from medicine, which is necessary fort the right solution of the task. Next part dedicates to nonlinear mechanics, constitutive modeling from the view of biomechanice and computational modeling of arteries. In the next part is made analysis for load on artery by physiological and also by high blood pressure. In the end were specified uncertainties of the used model and evaluated chance of atherosclerotic plaque rupture.

<p>UVOD: Uspe&scaron;nost revaskularizacije aortoilijačne bolesti procenjuje se prohodno&scaron;ću (patentno&scaron;ću) nakon revaskularizacije i brojem komplikacija. Osnovni cilj ove studije je bio utvrditi da li postoji razlika u učestalosti komplikacija, prohodnosti (patentnosti) i uticaj prohodnosti arterija donjeg vaskularnog korita na rekonstrukcije aortoilijačne bolesti nakon lečenja endovaskularnim i klasičnim hirur&scaron;kim pristupom. MATERIJAL I METODOLOGIJA: uzorak je činilo 229 bolesnika lečenih od aortoilijačne bolesti koji su pripadali TASC-u B i C a nakon procene prohodnosti femoropoplitealnog segmenta kao i broja prohodnih potkolenih arterija, bolesnici su stratifikovani u dve glavne grupe a svaka grupa od po tri podgrupe prema kvalitetu utočnog korita. Prvu grupu čine bolesnici sa jednoetažnom ili multiplim kraćim lezijama aortoilijačne signifikantne stenoze, sa ne signifikantnom aortoilijačnom stenozom i sa aortoilijačnom okluzijom. Drugu grupu čine bolesnici sa vi&scaron;eetažnom aortoilijačnom signifikantnom stenozom uz signifikantnu femoropoplitealnu stenozu i/ili popliteokruralnu stenozu. Studija je kreirana kao retrospektivna i prospektivna gde smo pratili rezultate revaskularizacije endovaskularnim procedurama i klasičnim hirur&scaron;kim pristupom. REZULTATI: Računanjem Mahalanobisove distance između homogenost jednoetažne, multiplih kraćih lezija i vi&scaron;eetažne aortoilijačne bolesti kod ispitivanih bolesnika dobija se najmanje rastojanje između homogenost jednoetažne, multiplih kraćih lezija i vi&scaron;eetažne aortoilijačne bolesti zato smo se i rukovodili da jednoetažne lezije, multiple kraće lezije tretiramo endovaskularnim procedurama a vi&scaron;eetažne lezije klasičnim hirur&scaron;kim pristupom. Nije bilo statističke značajne razlike među komplikacijama endovaskularnih procedura i klasičnog hirur&scaron;kog pristupa p&gt;0,1. U lečenju aortoilijačne bolesti endovakularne procedure imaju manji broj bolničkih dana, podjednaku primarnu asistiranu patentnost ali ne&scaron;to slabiju primarnu patentnost u odnosu na klasični hirur&scaron;ki pristup dok je sekundarna patentnost neznatno lo&scaron;ija od klasičnog hirur&scaron;kog pristupa. Da bi smo odreditli uticaj prohodnosti arterija donjeg vaskularnog korita na rekonstrukcije aortoilijačne bolesti kreirali smo matematički model kome smo dali obeležja prema kome bi mogli prognozirati smanjenje primarne patenosti nakon aortoilijačne revaskularizacije endovaskularnim procedurama i klasičnim hirur&scaron;kim pristupom. Postojanjem značajnih razlika između stepena patentnosti u odnosu na obeležja faktora rizika, definisali smo funkciju razgraničenja svih mogućih kombinacija od dva stepena patentnosti. Na osnovu te funkicije (x) moguće je izvr&scaron;iti prognozu kom stepenu patentnosti pripada (dobra,solidna, lo&scaron;a) za bolesnike koji nisu obuhvaćeni ovom studijom, kao i pouzdanost tom stepenu. ZAKLJUČAK: Aortoilijačna bolest je u većini slučajeva udružena sa bole&scaron;ću donjeg vaskularnog korita. Bez obzira na ekstenzivnost aortoilijačne bolesti endovaskularne procedure su efektivna i bezbedna, adekvatna alternativa klasičnom hirur&scaron;kom pristupu. Ova studija pokazuje da su endovaskularne procedure i klasični hirur&scaron;ki pristup u lečenju aortoilijačne bolesti komplementarne a ne komparativne metode.</p> / <p>BACKGROUND. The effectiveness of revascularization aortoiliac occlusive disease is the estimated patency after revascularization and is connected to the number of complications. The main objective of this study was to determine whether there is a difference in the incidence of complications and patency of lower artery vascular tree on the reconstruction aortoiliac occlusive disease after treatment of endovascular and conventional surgical approach. MATERIAL AND METHODOLOGY: The sample consisted of 229 patients treated for the aortoiliac occlusive disease who belonged in TASC B and C after a mobility assessment of the femoropopliteal segment and the number of walk-on below knee arteries, patients were stratified into two groups and each group of three subgroups according to the quality of the inflow. The first group consists of patients with one storey or multiple shorter lesions, and aortoiliac significant stenosis with aortoiliac not as significant stenosis and occlusion aortoiliac. The second group consists of patients with multi-floor aortoiliac significant stenosis with a significant femoropopliteal stenosis and/or popliteocrural stenosis. The study was designed as a retrospective and prospective study, where we track the results of endovascular revascularization procedures and compare to the conventional surgical approach. RESULTS: By calculating the Mahalanobis distance between the homogeneity of one story, multiple lesions and multi-storey short aortoiliac occlusive disease the studied patients received a minimum distance between the homogeneity of one story, multiple lesions and multi-storey short aortoiliac disease, multiple lesions treated fewer endovascular procedures and multi-storey lesions than a classical surgical approach. There were no statistically significant differences among the complications of endovascular procedures and classic surgical approach p&gt; 0.1. The patients treated with aortoiliac (endovascular) procedure have fewer hospital days, equal-assisted primary patent protection or slightly less primary patent protection compared to a traditional surgical approach while secondary patent protection is slightly worse than the classic surgical approach. In order to determine the impact of vascular patency of the arteries of the lower stories to the reconstruction treatment of aortoiliac occlusive diseases, we have created a mathematical model to which we gave the characteristics by with which it could predict the reduction of primary patency of aortoiliac revascularization after endovascular procedures and the conventional surgical approach. The existence of significant differences between the degree of patent protection in relation to the characteristics of the risk factors, we have defined the function of the demarcation of all possible combinations of two degrees of patent protection. Based on this function of (x) it is possible to forecast to what extent patent protection belongs (good, solid&sbquo; bad) for patients who are not included in this study, as well as the reliability of this level. CONCLUSION: the aortoiliac occlusive disease is in most cases associated with vascular disease of the lower artery vascular tree. Regardless of the extensiveness of the disease, aortoiliac occlusive disease endovascular procedures are safe and effective, an adequate alternative to the conventional surgical approach. This study shows that endovascular procedures and the conventional surgical approach in the treatment of aortoiliac occlusive diseases with a complementary rather than competitive method.</p>