Long-term Outcome of 121 Iliofemoral Endarterectomy Procedures

Long-term results of combined common femoral endarterectomy and iliac stenting/stent grafting for occlusive disease

“…1,2 The management of disease that extends proximally into the external iliac arteries (EIAs) is a more challenging problem. According to the recently modified guidelines from the Trans Atlantic Society Consensus (TASC II) document, external iliac disease involving the CFA is now classified as either TASC C or D depending on the extent of iliac involvement.…”

A national Vascular Quality Initiative database comparison of hybrid and open repair for aortoiliac-femoral occlusive disease

“…This observation reflects the treatment paradigm shift of the last decade of increased use of endovascular and hybrid techniques as the first-line strategy of treatment, even for extensive lesions traditionally treated with open repair. [5][6][7] To our knowledge, this study is the largest population-based study to date comparing surgical and endovascular or hybrid treatment of aortoiliac-femoral occlusive disease with access to periprocedural and follow-up clinical data and the first to reveal a higher improvement in ABI and ambulatory functional status in patients who underwent open revascularization compared with patients who underwent a hybrid approach.…”

Eversion endarterectomy of the external iliac artery

“…Another advantage of endarterectomy in general, including eversion endarterectomy, is a possibility to maintain better sexual potency, because it allows avoiding preparation of the aortic walls and common iliac arteries. The group of patients who would potentially benefit better from endarterectomy rather than bypass in aortoiliac segment includes the patients with atherosclerotic lesions not extending to common iliac arteries, the male patients who, apart from ischae mia of lower limbs, suffer also from erection disorders and diagnosed atherosclerotic stenosis or occlusion of an internal iliac artery, the patients with atherosclerotic occlusion of external iliac arteries with considerable risk of infections after bypass procedures or for whom, due to their narrow blood vessels, bypass is technically difficult, the patients with "localized" atherosclerotic lesions, and last but not least, the patients with bifur cated graft with endtoside anastomosis who need to have the prosthesis removed due to infection -in such cases the authors of this paper suggest endarterectomy as one of the alternative "rescue" solutions [10][11][12][13][14][15][16][17]. Currently, the value of direct aortoiliac endarterecto my has been reminded by Connoly and Price [12], and yet, they raise a question in the title of their paperwhether aortoiliac endarterectomy is a lost art.…”

“…The primary patency after 5 years is reported at 80-90%, the secondary one at 88-96% [10,11,13,15]. Also longterm observa tions can be found where cumulative patency 10 years after the surgery reaches even 85-89% [12,18].…”