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Treatment of the aorto-iliac segment in complex lower extremity arterial occlusive disease

A Wressnegger1, C Kinstner, M Funovics

  • 1Cardiovascular and Interventional Radiology Department of Biomedical Imaging and Image‑Guided Therapy Medical University of Vienna, Vienna, Austria - martin.funovics@meduniwien.ac.at.

The Journal of Cardiovascular Surgery
|December 6, 2014
PubMed

Insights

Endovascular treatment is effective for aortoiliac occlusive disease, offering high patency and lower risks than surgery, especially for TASC C and D lesions in high-risk patients.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Therapies

Background:

  • Endovascular treatment is established for TASC A and B aortoiliac occlusive disease.
  • Modern stent technology yields high one-year primary patency rates (>95%).

Purpose of the Study:

  • To evaluate the efficacy and safety of endovascular treatment for aortoiliac occlusive disease.
  • To compare endovascular approaches (provisional vs. primary stenting) and outcomes versus open surgery.

Main Methods:

  • Review of recent studies on endovascular stent technology for aortoiliac lesions.
  • Analysis of evidence comparing endovascular techniques with open surgical repair.
  • Assessment of outcomes including primary patency, complication rates, and mortality.

Main Results:

  • One-year primary patency exceeds 95% with modern stent technology.
  • Provisional stenting is supported for stenoses, while primary stenting is indicated for occlusions.
  • Endovascular treatment demonstrates lower complication and mortality rates than open surgery, despite potentially lower patency.

Conclusions:

  • Endovascular treatment is a viable and safe option for aortoiliac occlusive disease, including TASC C and D lesions.
  • It offers a favorable risk profile, particularly for patients unsuitable for open surgery.
  • Current guidelines may need revision regarding the exclusive surgical recommendation for complex lesions.

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