title: [Comparison of mid-term outcomes between surgical treatment and endovascular reconstruction for chronic aortoiliac occlusion].
abstract: OBJECTIVE
  To compare mid-term results of surgical treatment with aortoiliac stenting (AIS) in patients with chronic aortoiliac occlusion.
  
  
  METHODS
  A retrospective review of 68 patients treated between January 2005 and December 2010 was performed. Thirty-three patients underwent surgical revascularization (surgical group) and 35 patients underwent AIS (AIS group). Preoperative clinical factors and outcome data including complications, ankle-brachial index and mortality were collected. Kaplan-Meier estimates for survival, limb salvage and patency were analyzed.
  
  
  RESULTS
  Preoperative risk factors were similar between the two groups. Surgical group were younger than AIS group ((56±11) years vs. (65±10) years, t=-2.789, P=0.008) with more patients manifesting rest pain (23/33 vs.15/35, χ2=4.963, P=0.026) and relative higher perioperative mortality (3/33 vs. 0/35, P=0.109). Mean ankle-brachial index increased significantly in both groups after operation (Surgical group 0.90±0.15 vs. 0.43±0.20, t=-7.849, P=0.000; AIS group 0.85±0.20 vs. 0.41±0.25, t=-5.379, P=0.000). Postoperative complications occurred, with statistically higher rates of respiratory failure, transient renal dysfunction and multiple organ dysfunction syndrome in surgical group (χ2=6.98, P=0.010; χ2=9.62, P=0.000; P=0.023). The 5-year primary patency in surgical group was 90.2%, compared with 64.2% in AIS group (χ2=3.717, P=0.054). No difference was observed in survival rate, limb salvage and secondary patency between the two groups.
  
  
  CONCLUSIONS
  Five-year primary patency of endovascular reconstruction for chronic aortoiliac occlusion is lower than that for traditional open surgery. Open surgery is still the first choice for the patients who can endure the surgery. Endovascular treatment is an option for patients with high risk. However, additional interventional treatment is needed in some cases.
authors.affiliation: Department of Vascular & Thyroid Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Lun
authors.affiliation: Department of Vascular & Thyroid Surgery, the First Hospital of China Medical University, Shenyang 110001, China; Email: jianzhang.cmu@aliyun.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Vascular & Thyroid Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Shikai
authors.initials: S
authors.lastname: Shen
authors.affiliation: Department of Vascular & Thyroid Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Qingwei
authors.initials: Q
authors.lastname: Gang
authors.affiliation: Department of Vascular & Thyroid Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Vascular & Thyroid Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Han
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Vascular & Thyroid Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Shijie
authors.initials: S
authors.lastname: Xin
authors.affiliation: Department of Vascular & Thyroid Surgery, the First Hospital of China Medical University, Shenyang 110001, China.
authors.forename: Zhiquan
authors.initials: Z
authors.lastname: Duan
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D006801:Humans; D023821:Limb Salvage; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures