Aorto-Uni-Iliac Stent Grafts with and without Crossover Femorofemoral Bypass for Treatment of Abdominal Aortic Aneurysms: A Parallel Observational Comparative Study

Abstract EN

We investigated the safety and efficacy of primary aorto-uni-iliac (AUI) endovascular aortic repair (EVAR) without fem-fem crossover in patients with abdominal aortic aneurysm (AAA) and concomitant aortoiliac occlusive disease.

537 EVARs were implemented between 2002 and 2015 in University Hospital Galway, a tertiary referral center for aortic surgery and EVAR.

We executed a parallel observational comparative study between 34 patients with AUI with femorofemoral crossover (group A) and six patients treated with AUI but without the crossover (group B).

Group B patients presented with infrarenal AAAs with associated total occlusion of one iliac axis and high comorbidities.

Technical success was 97% ( n = 33 ) in group A and 85% ( n = 5 ) in group B ( P = 0.31 ).

Primary and assisted clinical success at 24 months were 88% ( n = 30 ) and 12% ( n = 4 ), respectively, in group A, and 85% ( n = 5 ) and 15% ( n = 1 ), respectively, in group B ( P = 0.125 ).

Reintervention rate was 10% ( n = 3 ) in group A and 0% in group B ( P = 0.084 ).

No incidence of postoperative critical lower limb ischemia or amputations occurred in the follow-up period.

AUI without crossover bypass is a viable option in selected cases.