title: Long-term results of combined aortoiliac and infrainguinal arterial reconstruction for the treatment of critical limb ischemia.
abstract: OBJECTIVE
  This study was designed to investigate our long-term experience with combined iliac endovascular therapy (EVT) and infrainguinal bypass to treat critical limb ischemia (CLI) and compare outcomes to those of patients who underwent surgery for aortoiliac lesions.
  
  
  METHODS
  From April 2000 to June 2013, 57 patients (58 limbs) underwent an infrainguinal bypass combined with aortoiliac reconstruction to treat CLI. Eighteen limbs were treated by bypass alone and 8 limbs were treated by bypass with EVT for aortoiliac lesions (Bypass group). Thirty-two limbs were subjected to EVT alone for iliac lesions (EVT group).
  
  
  RESULTS
  Preoperative limb ischemia was more severe in the EVT group. There were no significant differences in major procedure-related complications (χ(2) test, P = 0.853), systemic complications (P = 0.853), and mortality (P = 0.916) between the 2 groups. The limb salvage rates were 92% at 1, 3, and 5 years in the Bypass group and 93% at 1, 3, and 5 years in the EVT group, with no significant difference observed between the groups (Kaplan-Meier, log-rank test, P = 0.616).
  
  
  CONCLUSIONS
  Infrainguinal surgical reconstruction combined with an iliac EVT is an acceptable strategy for managing patients with CLI.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyahara
authors.affiliation: Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Shigematsu
authors.affiliation: Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Nishiyama
authors.affiliation: Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Hashimoto
authors.affiliation: Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Hoshina
authors.affiliation: Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Watanabe
keywords: critical limb ischemia; endovascular treatment; hybrid procedure
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