title: Retrograde thrombendarterectomy vs. ilio-femoral bypass in unilateral iliac TASC C and D lesions.
abstract: BACKGROUND
  To compare short and long term results of retrograde Thrombendarterectomy (rTEA) and ilio-femoral Bypass (IFBP) to treat iliac TASC C and D lesions.
  
  
  METHODS
  Retrospective analysis of 108 patients treated at a single vascular center by either rTEA (n = 42) or IFBP (n = 66) over a period of 4 years.
  
  
  RESULTS
  Both methods did not significantly differ in 30-day (rTEA 0 % vs IFBP 2 %) or long-term mortality (rTEA 24 % vs IFBP 30 % at 4 years) with a median follow-up of 46 months. There were no procedure related deaths. Patency was similar for both groups (rTEA 93 % vs IFBP 98 % at 30 days; rTEA 83 % vs 92 % IFBP at 4 years). We could not find a significant difference in limb salvage rates (rTEA 93 % vs IFBP 100 % at 30 days and at 4 years). The incidence of prolonged lymphorrhea was significantly higher in the IFBP group (rTEA 0 % vs IFBP 21 %). In 4 IFBP patients a prosthetic graft infection occurred.
  
  
  CONCLUSIONS
  Regarding short and long term results operative procedures as rTEA and IFBP still represent the gold standard in the treatment of TASC C and D lesions of the external iliac artery especially in patients with additional lesions in the common femoral and profundal femoral artery. Taking into account certain anatomical characteristics (heavily calcified lesions, narrow external iliac arteries or very tortuous iliac segments) and individual local conditions (prior vascular procedures involving the femoral bifurcation) the single incision retrograde approach to the EIA with rTEA may have advantages over IFBP, especially concerning postoperative complications like lymphorrhea and graft infection.
authors.affiliation: 1 Krankenhaus Barmherzige Brüder Regensburg, Germany.
authors.forename: Ingolf
authors.initials: I
authors.lastname: Töpel
authors.forename: Matthias
authors.initials: M
authors.lastname: Wiesner
authors.forename: Christian
authors.initials: C
authors.lastname: Uhl
authors.forename: Thomas
authors.initials: T
authors.lastname: Betz
authors.forename: Markus G
authors.initials: MG
authors.lastname: Steinbauer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D003251:Constriction, Pathologic; D004691:Endarterectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology / Q000601:surgery*; D005858:Germany; D006801:Humans; D007083:Iliac Artery / Q000503:physiopathology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: Peripheral artery disease; ilio-femoral bypass; retrograde thrombendarterectomy