Endovascular Reconstruction for Chronic Infrarenal Aortoiliac Occlusive Disease

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Therapy

Background:

• The TransAtlantic Inter-Society Consensus (TASC II) guidelines recommend surgery for extensive aortoiliac occlusive disease (AIOD) (TASC II C and D).
• Endovascular management is increasingly recognized as an effective first-line treatment for TASC II C and D lesions.
• Limited data exists on endovascular approaches for the most severe TASC II D subset: chronic infrarenal aortoiliac occlusion (CIAO).

Observation:

• This study presents a novel endovascular technique for treating CIAO.
• The technique involves bidirectional subintimal aortoiliac dissection, wire snare true lumen reentry, and stent reconstruction.
• Covered stents (balloon-expandable and self-expanding) are used for the aortic bifurcation and iliac arteries.

Findings:

• The described endovascular technique successfully treats CIAO, extending minimally invasive options to severe TASC II D AIOD.
• This approach provides a viable alternative to aortobifemoral bypass surgery for CIAO patients.
• The technique demonstrates safety in treating this complex subset of AIOD.

Implications:

• This minimally invasive strategy may reduce patient morbidity associated with open surgical repair of CIAO.
• Further research with larger cohorts and long-term follow-up is necessary to confirm the clinical efficacy and durability of this endovascular technique.
• This approach broadens the application of endovascular interventions in complex vascular disease management.