title: Trans-Atlantic Inter-Society Consensus II C and D iliac lesions can be treated by endovascular and hybrid approach: a single-center experience.
abstract: OBJECTIVE
  To evaluate the long-term results of endovascular and hybrid treatment in patients with Trans-Atlantic Inter-Society Consensus (TASC) II type "C" and "D" aortoiliac lesions and to highlight, in contrast to TASC II guidelines, the importance to analyze individually the lesions of a single iliac axis.
  
  
  METHODS
  From January 2008 to December 2012, 50 patients with TASC II type C and D aortoiliac lesions underwent endovascular or hybrid treatment. In 38 patients (76%), the lesions were treated by endovascular approach, while in 12 (24%) patients surgical treatment was adopted. All patients underwent a postoperative surveillance program at 1, 3, and 6 months for the first year and every 6 months thereafter.
  
  
  RESULTS
  Technical success was achieved in all patients (100%). The postoperative complication rate was 4%. Primary patency rate was 93.3% at 1 year, 90.2% at 2 years, and 86.6% at 3 years. Cumulative secondary patency rate was 97.7% at 1, 2, and 3 years. Survival after 1 and 2 years was 94.8% and after 3 years was 91.1%. Limb salvage was 100% for the entire period of follow-up.
  
  
  CONCLUSIONS
  In contrast to TASC II guidelines, the endovascular or hybrid treatment should be considered a valid approach for type C and D lesions. The hybrid treatment, in selected cases, is an effective method to improve the runoff, which plays a key role in the success of the treatment of multilevel stenoocclusive lesions. In TASC II C to D iliac lesions, a specific overview of each axis is necessary in order to select the most appropriate treatment.
authors.affiliation: 1Department of Vascular Surgery, Sant'Andrea Hospital, University of Rome-"La Sapienza", Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Taurino
authors.forename: Francesca
authors.initials: F
authors.lastname: Persiani
authors.forename: Cristiano
authors.initials: C
authors.lastname: Fantozzi
authors.forename: Roberta
authors.initials: R
authors.lastname: Ficarelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Rizzo
authors.forename: Nazzareno
authors.initials: N
authors.lastname: Stella
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007083:Iliac Artery / Q000503:physiopathology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000145:classification / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012384:Rome; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: aortoiliac TASC II type C and D lesions; endovascular treatment; hybrid treatment; peripheral occlusive diseases