Bifurcated endoprosthesis for treatment of aortoiliac occlusive lesions.
OBJECTIVE
To report our initial experience with a bifurcated endoprosthesis in the management of aortoiliac occlusive disease.


METHODS
From May 2001 to February 2004, 112 patients were referred to our institution for the management of aortoiliac disease. Among these, 5 (6%) patients (3 men; mean age 57.8 years) with severe ischemia owing to TASC C or D iliac occlusions were selected for endovascular treatment with a bifurcated stent-graft. An Excluder stent-graft was placed after preliminary recanalization (thrombolysis and/or balloon dilation) the day before. The patients were followed clinically and ultrasonographically every 3 months during the first year and semiannually thereafter.


RESULTS
Technical success was achieved in all patients. Endovascular aortoiliac bifurcation reconstruction restored iliac artery flow immediately in all cases. There were no procedure-related complications. The mean ankle-brachial index (ABI) was significantly improved, from 0.66+/-0.04 before the procedure to 0.94+/-0.06 immediately after the procedure (p<0.01). The aortoiliac reconstructions remained patent during the mean 17-month follow-up (range 3-36), and the ABIs were stable. There was no mortality or amputation required in this series.


CONCLUSIONS
Endovascular placement of a bifurcated stent-graft appears to be technically feasible, effective, and safe in the management of aortoiliac occlusive disease.
Maynar
Manuel
M
Hospiten Rambla, Las Palmas de Gran Canaria University, Santa Cruz de Tenerife, Spain.
Zander
Tobias
T
Qian
Zhong
Z
Rostagno
Roman
R
Llorens
Rafael
R
Zerolo
Ignacio
I
Kirsch
David
D
Sorrells
Lisa
L
Castañeda
Wilfrido R
WR
D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods*; D001012:Aorta, Abdominal; D001027:Aortography; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014654:Vascular Patency