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Bifurcated endograft in aortoiliac type C and D lesions: long-term results
Tobias Zander1, Oscar Blasco, Martin Rabellino
1Department of Endovascular Therapy, Hospital Hospiten Rambla, Rambla de Santa Cruz 115, 38001 Santa Cruz de Tenerife, Spain. tobiaszander@gmx.de
Insights
Bifurcated aortic endografts show promising long-term outcomes for treating severe aortoiliac occlusive disease (AIOD) in high-risk patients. This minimally invasive approach offers a viable alternative to open surgery.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aortoiliac Disease Management
Background:
- Aortoiliac occlusive disease (AIOD) poses significant challenges, particularly in patients with Trans Atlantic Inter Society Consensus (TASC) C and D classifications.
- High surgical risk often precludes traditional open repair for these patients.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of bifurcated aortic endografts in treating TASC C and D AIOD.
- To assess the durability and patency rates of endovascular repair in this complex patient cohort.
Main Methods:
- A cohort of 14 high-risk patients with TASC C/D AIOD underwent treatment with bifurcated aortic endografts.
- Follow-up included clinical assessment and computed tomography (CT) scans at regular intervals for up to 96 months.
Main Results:
- Technical success rate was 100% with no 30-day mortality or amputations.
- Mean follow-up was 62 months, with primary patency of 85.7% and secondary patency of 100%.
- Two cases of limb occlusion were successfully managed with intra-arterial fibrinolysis.
Conclusions:
- Bifurcated aortic endografts demonstrate promising long-term results for AIOD TASC C and D lesions.
- This endovascular technique is a safe and effective minimally invasive alternative to open surgery for high-risk individuals.
Purpose:
To report long-term outcome when using a bifurcated aortic endograft for treatment of aortoiliac occlusive disease (AIOD) in Trans Atlantic Inter Society Consensus (TASC) classification C and D patients.
Materials And Methods:
Between May 2001 and May 2009, 14 patients (11 men, 3 women) with aortoiliac TASC C and D type lesions and a mean age of 59 years ± 10 (range 41-73 years) were treated using a bifurcated aortic endograft. Although these patients were young, all were considered at high surgical risk. Patients were followed up clinically and by computed tomography (CT) every 3 months for 1 year and yearly thereafter.
Results:
Endoprosthesis placement was performed in all patients with a technical success rate of 100%. There were no amputations or deaths at 30 days after the procedure. The mean follow-up was 62 months (range 11-96 months). One patient was lost during follow-up at 11 months, and another patient died of a nonrelated cause after 49 months. A single limb occlusion of the prosthesis was seen in two patients at 2 months and 7 months; both were successfully treated by intraarterial fibrinolysis. At a mean follow-up of 62 months, primary patency was 85.7%, and secondary patency was 100%.
Conclusions:
This series shows promising long-term results following the use of a bifurcated aortic endograft for treatment of AIOD TASC C and D type lesions. Bifurcated aortic endograft is a good minimally invasive alternative to open surgery in high surgical risk patients.
