Endovascular grafting for aortoiliac occlusive disease
L A Sanchez1, R A Wain, F J Veith
1Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY 10467-2490, USA.
Insights
New endovascular grafts show promising results for treating extensive aortoiliac occlusive disease, offering a less invasive option. Early data indicate high patency and limb salvage rates, suggesting a potential advancement in managing lower extremity ischemia.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Cardiovascular Disease
Background:
- Aortoiliac occlusive disease frequently causes lower extremity ischemic symptoms.
- Traditional treatments include aortofemoral bypass and extra-anatomic bypasses.
- Percutaneous angioplasty and stenting are effective for limited iliac lesions.
Purpose of the Study:
- To evaluate the efficacy of novel endovascular grafts for extensive aortoiliac occlusive disease.
- To assess the feasibility of a less invasive treatment approach.
- To report early clinical outcomes of this new technology.
Main Methods:
- Endovascular grafts constructed with Palmaz balloon-expandable stents and polytetrafluoroethylene (PTFE) grafts were used.
- Patients with extensive aortoiliac occlusive disease were treated.
- Clinical outcomes including patency and limb salvage rates were analyzed.
Main Results:
- The 18-month primary patency rate was 89%.
- The 18-month secondary patency rate was 100%.
- The limb salvage rate was 94%.
Conclusions:
- Endovascular grafts can effectively treat extensive aortoiliac occlusive disease with excellent early results.
- This less invasive approach shows significant potential for managing lower extremity ischemia.
- Long-term outcomes and further graft development are crucial for defining their definitive role.
Abstract:
Aortoiliac occlusive disease is a significant cause of lower extremity ischemic symptoms. Over the past two decades, most patients have been treated with a variety of surgical procedures, including aortofemoral and extra-anatomic bypasses. Most recently, percutaneous balloon angioplasty and stents have been successfully used for the treatment of limited iliac lesions. New endovascular grafts that combine vascular grafts with stents in a device with new characteristics may allow the successful treatment of patients with extensive aortoiliac occlusive disease in a less invasive fashion. In our early experience, the endovascular grafts were constructed with Palmaz balloon-expandable stents and standard polytetrafluoroethylene (PTFE) grafts. The 18-month primary and secondary patency rates were 89% and 100%, respectively, with a limb salvage rate of 94%. Endovascular grafts can be successfully used to treat patients with extensive aortoiliac occlusive disease, with excellent early results. Long-term results and further graft improvements will define their role in the treatment of patients with aortoiliac occlusive disease.
