title: Combined direct repair and inline inflow stenting in the management of aortoiliac disease extending into the common femoral artery.
abstract: OBJECTIVE
  Describe a hybrid approach to simplify management of complex aortoiliac occlusive disease (AIOD) extending into the common femoral artery (CFA).
  
  
  METHODS
  Retrospective review of 56 patients who underwent hybrid management of AIOD extending into CFA between January 2003 and February 2007. Two distinct hybrid approaches were compared: Inline (iliac stenting continuous with an open CFA reconstruction, 38 limbs in 37 patients) and tandem (noncontiguous stenting of an upstream iliac segment, 20 limbs in 19 patients). The median follow-up duration was 15 ± 12 months in the inline group and 24 ± 12 months in the tandem group.
  
  
  RESULTS
  Technical success was achieved in all but 1 procedure. Clinical and hemodynamic responses to the interventions and limb loss rates were comparable in both groups. Survival table analysis showed no significant difference between inline and tandem reconstructions.
  
  
  CONCLUSIONS
  Inline stenting represents a lesser invasive revascularization choice in complex AIOD with contiguous involvement of the CFA.
authors.affiliation: Department of Surgery, The University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA, USA. mel-sharafuddin@uiowa.edu
authors.forename: Melhem J
authors.initials: MJ
authors.lastname: Sharafuddin
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Kresowik
authors.forename: Jamal J
authors.initials: JJ
authors.lastname: Hoballah
authors.forename: Rachael M
authors.initials: RM
authors.lastname: Nicholson
authors.forename: William J
authors.initials: WJ
authors.lastname: Sharp
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001018:Aortic Diseases / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D007083:Iliac Artery / Q000503:physiopathology / Q000601:surgery*; D007484:Iowa; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality