title: Seven-Year Approach Evolution of the Aortoiliac Occlusive Disease Endovascular Treatment.
abstract: BACKGROUND
  Endovascular treatment is now considered the first-line therapy for the aortoiliac occlusive disease (AIOD). We report our experience with the total endovascular treatment of infrarenal and pararenal aortoiliac occlusions and the 7-year approach evolution.
  
  
  METHODS
  A total of 22 patients underwent total endovascular treatment of AIOD from January 2008 to September 2014. Bare metal stents in kissing configuration were deployed in 9 cases, covered stents in kissing configuration in 9 patients and the aortic bifurcation reconstruction with the Y-guidewire configuration technique was performed in the last 4 patients.
  
  
  RESULTS
  Technical success was 100%. Perioperative mortality rate was 4.5%. ankle-brachial index improved from 0.49 ± 0.19 to 0.96 ± 0.05 at the right side and from 0.53 ± 0.17 0.98 ± 0.04 at the left side (P < 0.01). Mean follow-up was 39.5 months (range, 5-80 months). The primary patency rate was 95.2% at 1 year and 90.5% at 3 years, and the secondary patency rate was 95.2% at 1 year and 100% at 3 years.
  
  
  CONCLUSIONS
  Different stent types and configurations used for the aortoiliac endovascular treatment offer all the benefits of these materials for treatment on a case-by-case basis. The Y-guidewire configuration technique for the aortic bifurcation reconstruction may render the procedure more feasible. More cases and longer follow-up are necessary before the widespread use of this technique.
authors.affiliation: Vascular Surgery Unit, Department of Surgery, "San Francesco" Hospital, Nuoro, Italy; Vascular Surgery Unit, Department "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy. Electronic address: kasemiholta@libero.it.
authors.forename: Holta
authors.initials: H
authors.lastname: Kasemi
authors.affiliation: Vascular Surgery Unit, Department of Surgery, "San Francesco" Hospital, Nuoro, Italy; Vascular Surgery Unit, Department "Paride Stefanini", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Marino
authors.affiliation: Vascular Surgery Unit, Department of Surgery, Cardinal Panico Hospital, Lecce, Italy.
authors.forename: Carlo Patrizio
authors.initials: CP
authors.lastname: Dionisi
authors.affiliation: Vascular Surgery Unit, Department of Surgery, "San Francesco" Hospital, Nuoro, Italy.
authors.forename: Costantino Luca
authors.initials: CL
authors.lastname: Di Angelo
authors.affiliation: Vascular Surgery Unit, Department of Surgery, "San Francesco" Hospital, Nuoro, Italy.
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Fadda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency