Treatment Outcomes of Endovascular Therapy for Leriche Syndrome

Abstract

Objective: The previous standard method for revascularization in Leriche syndrome was open surgery (OS). However, there has been a recent increase in the use of endovascular therapy (EVT), which has shown improved treatment outcomes compared with OS. We report the treatment outcomes of EVT for Leriche syndrome in our department. Methods: We examined 32 patients with 57 legs with Leriche syndrome that underwent revascularization between 2001 and 2022 (mean age 72±10 years, 27 males). The primary endpoint was the 5-year primary patency rate. The secondary endpoints were the postoperative ankle-brachial index (ABI), complications, hospital stay, and efficacy of EVT. Results: The initial technical success rate in the EVT group was 85% (18/21). The EVT group comprised 20 patients with 33 affected legs, while the OS group comprised 12 patients with 24 affected legs. There was no significant difference between the two groups in the preoperative ABI (p=0.17). The postoperative ABI was also similar in the EVT group (0.86±0.18) and the OS group (0.86±0.20) (p=0.90). There were no postoperative complications reported in the EVT group, while the OS group had one case of sepsis and one of intestinal obstruction. Excluding Fontaine IV cases, the postoperative hospital stay was significantly shorter in the EVT group (9±5 days) than the OS group (18±7 days) (p<0.002). There were no remote complications reported in the EVT group, while the OS group had one case of graft infection and one of incisional hernia. The cumulative patency rates at 1, 3, and 5 years did not significantly differ between the EVT group (100, 93, and 93%, respectively) and the OS group (100, 89, and 89%, respectively) (p=0.475). Conclusion: EVT for Leriche syndrome is a minimally invasive treatment that reduces the hospital stay without causing complications. EVT was equally effective as OS and is a valuable option.