Thromboendarterectomy vs. aortic bifurcation graft for unilateral iliac artery atherosclerosis

Area of Science:

• Vascular Surgery
• Cardiovascular Medicine
• Surgical Outcomes

Background:

• Iliac and femoral artery occlusive disease often requires surgical intervention.
• Thromboendarterectomy and bypass grafting are common surgical options.
• Comparing the long-term efficacy of these procedures is crucial for patient outcomes.

Purpose of the Study:

• To compare the five-year cumulative patency rates of unilateral ilio-femoral thromboendarterectomy versus bifurcation grafts.
• To evaluate the clinical outcomes and indications for each surgical approach.

Main Methods:

• Retrospective analysis of 57 unilateral ilio-femoral thromboendarterectomies in 55 patients.
• Retrospective analysis of 42 bifurcation grafts in 42 patients.
• Comparison of hospital mortality, graft infection rates, and five-year cumulative patency.

Main Results:

• Three hospital deaths occurred (1 after thromboendarterectomy, 2 after bifurcation graft).
• No early or late graft infections were reported in either group.
• The five-year cumulative patency rate was significantly higher for bifurcation grafts (85%) than for thromboendarterectomy (61%).

Conclusions:

• Bifurcation grafts demonstrate superior long-term patency compared to ilio-femoral thromboendarterectomy.
• Local thromboendarterectomy has limited indications for treating ilio-femoral artery disease.
• Bypass grafting with bifurcation grafts is a more durable solution for extensive ilio-femoral occlusive disease.