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Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
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Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound

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Aortoiliac: Covered, Uncovered, CERAB as It Relates to Peripheral Arterial Disease

Sayeh Bozorghadad1, Matthew J Scheidt1, Parag J Patel1

  • 1Department of Radiology, Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin.

Seminars in Interventional Radiology
|June 19, 2023
PubMed

Insights

Peripheral arterial disease (PAD) management is shifting. Endovascular techniques offer improved outcomes and reduced mortality compared to open surgery for aortoiliac disease.

Area of Science:

  • Vascular Surgery
  • Endovascular Interventions
  • Cardiovascular Medicine

Background:

  • Peripheral arterial disease (PAD) impacts over 200 million globally, posing significant mortality and amputation risks.
  • Historically, open surgery was the gold standard for aortoiliac disease, despite high perioperative mortality.
  • Advancements in endovascular technology are reshaping treatment paradigms for PAD.

Purpose of the Study:

  • To compare the efficacy of open surgery versus endovascular techniques for aortoiliac disease.
  • To highlight the benefits of adopting an endovascular-first approach in PAD management.
  • To review novel endovascular techniques like covered endovascular reconstruction of the aortic bifurcation.

Main Methods:

  • Comparative review of open surgical and endovascular treatment strategies for aortoiliac disease.
  • Analysis of technical success, primary, and secondary patency rates.
  • Evaluation based on TASC-II guidelines and current clinical evidence.

Main Results:

  • Endovascular techniques demonstrate increasing efficacy and wider adoption for aortoiliac disease.
  • Covered endovascular reconstruction shows excellent technical success and improved patency rates.
  • Endovascular approaches offer a potentially lower perioperative mortality risk compared to open surgery.

Conclusions:

  • A shift towards an endovascular-first approach for aortoiliac disease is supported by recent technological advancements and clinical outcomes.
  • Endovascular interventions provide a viable and effective alternative to open surgery, regardless of lesion complexity.
  • This approach aims to improve patient outcomes and reduce amputation rates in PAD management.

Keywords:
CERABaortaaortoiliac occlusive diseaseendovasculariliac arteryinterventional radiology

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