title: Comparison of midterm outcomes between surgical treatment and endovascular reconstruction for chronic infrarenal aortoiliac occlusion.
abstract: OBJECTIVE
  To compare the midterm results of aortoiliac stent (AIS) placement with those of surgical treatment in patients with chronic infrarenal aortoiliac occlusion.
  
  
  METHODS
  Midterm outcomes in patients treated at a single center from 2005 to 2010 were retrospectively reviewed. Correlations between baseline clinical factors and midterm outcomes were assessed.
  
  
  RESULTS
  The technical success rate was significantly lower in the AIS group than in the surgery group (83.3% vs 100%; P = .016). Of 68 technically successfully treated patients, 33 underwent surgical revascularization and 35 received AIS placement. There were no significant differences in patient demographics, Rutherford classification, cardiovascular risk factors, and 30-day mortality rates. Surgically treated patients had a longer average postoperative hospital stay (P = .001) and higher rates of postoperative complications, including respiratory failure (P = .010), transient renal dysfunction (P = .002), and multiple organ dysfunction (P = .023). Mean ankle-brachial index increased significantly in both groups (P < .001), but to the same extent. The primary 1-, 3-, and 5-year patency rates were 93.6%, 90.2%, and 90.2%, respectively, in the surgery group, and 91.4%, 81.8%, and 64.2%, respectively, in the AIS group (P = .054). No differences were observed in survival rate (P = .945), limb salvage (P = .860), or secondary patency (P = .916).
  
  
  CONCLUSIONS
  AIS for chronic infrarenal aortoiliac occlusion is associated with a shorter hospital stay and lower postoperative morbidity rates. Although midterm primary patency rate was lower than for traditional open surgery, AIS appears to be a safe, minimally invasive, and reliable procedure for patients with chronic infrarenal aortoiliac occlusion.
authors.affiliation: Department of Vascular Surgery, The First Hospital, China Medical University, Nanjing Bei Str. 155, Shenyang 110001, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Lun
authors.affiliation: Department of Vascular Surgery, The First Hospital, China Medical University, Nanjing Bei Str. 155, Shenyang 110001, China. Electronic address: cmu_zhangjian@163.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Vascular Surgery, The First Hospital, China Medical University, Nanjing Bei Str. 155, Shenyang 110001, China.
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Vascular Surgery, The First Hospital, China Medical University, Nanjing Bei Str. 155, Shenyang 110001, China.
authors.forename: Qingwei
authors.initials: Q
authors.lastname: Gang
authors.affiliation: Department of Vascular Surgery, The First Hospital, China Medical University, Nanjing Bei Str. 155, Shenyang 110001, China.
authors.forename: Shikai
authors.initials: S
authors.lastname: Shen
authors.affiliation: Department of Vascular Surgery, The First Hospital, China Medical University, Nanjing Bei Str. 155, Shenyang 110001, China.
authors.forename: Han
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Vascular Surgery, The First Hospital, China Medical University, Nanjing Bei Str. 155, Shenyang 110001, China.
authors.forename: Zhiquan
authors.initials: Z
authors.lastname: Duan
authors.affiliation: Department of Vascular Surgery, The First Hospital, China Medical University, Nanjing Bei Str. 155, Shenyang 110001, China.
authors.forename: Shijie
authors.initials: S
authors.lastname: Xin
mesh_terms: D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D002908:Chronic Disease; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome