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Abstract

Purpose:

To report our initial experience with a bifurcated endoprosthesis in the management of aortoiliac occlusive disease.

Methods:

From May 2001 to February 2004, 112 patients were referred to our institution for the management of aortoiliac disease. Among these, 5 (6%) patients (3 men; mean age 57.8 years) with severe ischemia owing to TASC C or D iliac occlusions were selected for endovascular treatment with a bifurcated stent-graft. An Excluder stent-graft was placed after preliminary recanalization (thrombolysis and/or balloon dilation) the day before. The patients were followed clinically and ultrasonographically every 3 months during the first year and semiannually thereafter.

Results:

Technical success was achieved in all patients. Endovascular aortoiliac bifurcation reconstruction restored iliac artery flow immediately in all cases. There were no procedurerelated complications. The mean ankle-brachial index (ABI) was significantly improved, from 0.66±0.04 before the procedure to 0.94±0.06 immediately after the procedure (p < 0.01). The aortoiliac reconstructions remained patent during the mean 17-month follow-up (range 3–36), and the ABIs were stable. There was no mortality or amputation required in this series.

Conclusions:

Endovascular placement of a bifurcated stent-graft appears to be technically feasible, effective, and safe in the management of aortoiliac occlusive disease.

Keywords

aortoiliac segment occlusive disease thrombolysis endovascular repair stent-graft

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Bifurcated Endoprosthesis for Treatment of Aortoiliac Occlusive Lesions