Comparison of Midterm Outcomes between Surgical Treatment and Endovascular Reconstruction for Chronic Infrarenal Aortoiliac Occlusion

Abstract Purpose To compare the midterm results of aortoiliac stent (AIS) placement with those of surgical treatment in patients with chronic infrarenal aortoiliac occlusion. Materials and Methods Midterm outcomes in patients treated at a single center from 2005 to 2010 were retrospectively reviewed. Correlations between baseline clinical factors and midterm outcomes were assessed. Results The technical success rate was significantly lower in the AIS group than in the surgery group (83.3% vs 100%; P = .016). Of 68 technically successfully treated patients, 33 underwent surgical revascularization and 35 received AIS placement. There were no significant differences in patient demographics, Rutherford classification, cardiovascular risk factors, and 30-day mortality rates. Surgically treated patients had a longer average postoperative hospital stay ( P = .001) and higher rates of postoperative complications, including respiratory failure ( P = .010), transient renal dysfunction ( P = .002), and multiple organ dysfunction ( P = .023). Mean ankle-brachial index increased significantly in both groups ( P P = .054). No differences were observed in survival rate ( P = .945), limb salvage ( P = .860), or secondary patency ( P = .916). Conclusions AIS for chronic infrarenal aortoiliac occlusion is associated with a shorter hospital stay and lower postoperative morbidity rates. Although midterm primary patency rate was lower than for traditional open surgery, AIS appears to be a safe, minimally invasive, and reliable procedure for patients with chronic infrarenal aortoiliac occlusion.