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Trans-Atlantic Inter-Society Consensus II C and D iliac lesions can be treated by endovascular and hybrid approach: a

Maurizio Taurino1, Francesca Persiani, Cristiano Fantozzi

  • 11Department of Vascular Surgery, Sant'Andrea Hospital, University of Rome-"La Sapienza", Rome, Italy.

Vascular and Endovascular Surgery
|November 26, 2013
PubMed

Insights

Endovascular and hybrid treatments are effective for severe aortoiliac lesions (TASC II C-D), challenging traditional guidelines. Individual lesion analysis is crucial for successful outcomes in complex cases.

Area of Science:

  • Vascular Surgery
  • Endovascular Interventions
  • Aortoiliac Disease Management

Background:

  • Trans-Atlantic Inter-Society Consensus (TASC) II guidelines traditionally recommend open surgical repair for TASC II type C and D aortoiliac lesions.
  • Complex aortoiliac occlusive disease presents significant challenges for revascularization.
  • Evaluating less invasive treatment options is critical for improving patient outcomes.

Purpose of the Study:

  • To assess the long-term efficacy of endovascular and hybrid revascularization for TASC II type C and D aortoiliac lesions.
  • To emphasize the importance of individualized lesion assessment over strict adherence to TASC II guidelines.
  • To determine the safety and patency rates of these advanced treatment modalities.

Main Methods:

  • A retrospective analysis of 50 patients with TASC II C and D aortoiliac lesions treated between January 2008 and December 2012.
  • Patients underwent either endovascular (76%) or hybrid (24%) treatment.
  • A comprehensive postoperative surveillance program was implemented, with regular follow-up intervals.

Main Results:

  • 100% technical success rate was achieved in all treated patients.
  • Low postoperative complication rate of 4% was observed.
  • Excellent long-term patency rates: primary patency of 86.6% at 3 years and secondary patency of 97.7% at 3 years.
  • High survival (91.1% at 3 years) and 100% limb salvage rates were reported.

Conclusions:

  • Endovascular or hybrid treatment represents a viable and effective alternative for TASC II type C and D aortoiliac lesions, contrary to conventional guidelines.
  • Hybrid approaches can significantly improve distal perfusion (runoff), which is vital for treating multilevel disease.
  • Individualized assessment of each iliac axis is paramount for selecting the optimal treatment strategy in complex cases.
Abstract

Keywords:
aortoiliac TASC II type C and D lesionsendovascular treatmenthybrid treatmentperipheral occlusive diseases

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