Results of endovascular therapy and aortobifemoral grafting for Transatlantic Inter-Society type C and D aortoiliac occlusive disease.
OBJECTIVE
The purpose of this study was to compare the outcomes of aortoiliac stenting (AIS) to those of aortobifemoral grafting (ABF) for patients with TransAtlantic Inter-Society Consensus (TASCII) C and D aortoiliac occlusive disease.


METHODS
From 1998 to 2007, 32 patients underwent ABF and 40 patients underwent AIS. Kaplan-Meier estimates for patency were used.


RESULTS
Patients undergoing AIS were older (66.6 years ABF vs 59.2 years AIS; P=.006). The ABF group had simultaneous profundoplasty (n = 8) and femoral-popliteal graft (n =1). Six patients had treatment for concomitant infrainguinal disease at the time of AIS. There was no mortality in either group. Average hospital stay in the ABF group was 7 +/- 2 days and 1 +/- 0.3 days for AIS (P = .0001). Pulmonary complications predominated in the ABF group (13%). Four patients in the AIS group (10%) developed intraprocedural complications. Primary patency at 48 months was 69 +/- .12% for AIS and 93 +/- .07% for ABF (P = .013). There was a significant increase in ankle-brachial indices after revascularization in both groups.


CONCLUSIONS
TASC type C and D lesions can be treated with either ABF or AIS with satisfactory results. Compared with ABF, AIS is associated with decreased primary patency, decreased perioperative morbidity, and shorter hospital stay.
Henry Ford Macomb Hospital, Clinton Township, MI, USA. sshans@comcast.net
Sachinder Singh
SS
Hans
Debbie
D
DeSantis
Rizwan
R
Siddiqui
Michael
M
Khoury
D000368:Aged; D017130:Angioplasty / Q000379:methods*; D001012:Aorta, Abdominal / Q000473:pathology / Q000601:surgery; D001027:Aortography; D001157:Arterial Occlusive Diseases / Q000145:classification* / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005263:Femoral Artery / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000473:pathology / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods