title: Aorto-Uni-Iliac Stent Grafts with and without Crossover Femorofemoral Bypass for Treatment of Abdominal Aortic Aneurysms: A Parallel Observational Comparative Study.
abstract: We investigated the safety and efficacy of primary aorto-uni-iliac (AUI) endovascular aortic repair (EVAR) without fem-fem crossover in patients with abdominal aortic aneurysm (AAA) and concomitant aortoiliac occlusive disease. 537 EVARs were implemented between 2002 and 2015 in University Hospital Galway, a tertiary referral center for aortic surgery and EVAR. We executed a parallel observational comparative study between 34 patients with AUI with femorofemoral crossover (group A) and six patients treated with AUI but without the crossover (group B). Group B patients presented with infrarenal AAAs with associated total occlusion of one iliac axis and high comorbidities. Technical success was 97% (n = 33) in group A and 85% (n = 5) in group B (P = 0.31). Primary and assisted clinical success at 24 months were 88% (n = 30) and 12% (n = 4), respectively, in group A, and 85% (n = 5) and 15% (n = 1), respectively, in group B (P = 0.125). Reintervention rate was 10% (n = 3) in group A and 0% in group B (P = 0.084). No incidence of postoperative critical lower limb ischemia or amputations occurred in the follow-up period. AUI without crossover bypass is a viable option in selected cases.
authors.affiliation: Vascular Surgery Unit, Department of Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt; Western Vascular Institute, National University of Ireland, Department of Vascular and Endovascular Surgery, University Hospital Galway, Newcastle Road, Galway, Ireland.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Elkassaby
authors.affiliation: Western Vascular Institute, National University of Ireland, Department of Vascular and Endovascular Surgery, University Hospital Galway, Newcastle Road, Galway, Ireland.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Alawy
authors.affiliation: Western Vascular Institute, National University of Ireland, Department of Vascular and Endovascular Surgery, University Hospital Galway, Newcastle Road, Galway, Ireland.
authors.forename: Mohamed Zaki
authors.initials: MZ
authors.lastname: Ali
authors.affiliation: Western Vascular Institute, National University of Ireland, Department of Vascular and Endovascular Surgery, University Hospital Galway, Newcastle Road, Galway, Ireland.
authors.forename: Wael A
authors.initials: WA
authors.lastname: Tawfick
authors.affiliation: Western Vascular Institute, National University of Ireland, Department of Vascular and Endovascular Surgery, University Hospital Galway, Newcastle Road, Galway, Ireland; The Galway Clinic, Royal College of Surgeon in Ireland, Dublin Road, Doughiska, Galway, Ireland.
authors.forename: Sherif
authors.initials: S
authors.lastname: Sultan