Combined iliac artery angioplasty and infrainguinal reconstruction in multilevel atherosclerotic disease

Abstract EN

Background: Patients with limb ischemia and diffuse aortoiliac or combined aortoiliac gndfemoropopliteal disease present as a difficult problem for surgeons, purpose: Is to present our early experience with the combined use of iliac artery angioplasty and infrainguinal surgical revascularization for the treatment of multilevel atherosclerotic disease.

Methods: Thirteen patients with iliac artery stenosis and femoropopliteal occlusive disease were treated with fem-pop grafting and iliac balloon angioplasty (IBA) which was performedpercutaneously within 1-2 days before surgery.

Stenting was performed for suboptimal IBA.

Graft patency way evaluated by clinical examination, duplex scarming/ankle-brachial index (ABI) at 1,3,6, and 12 months.

Results: Indications for surgery were limb salvage (46%), rest pain (23%), and claudication (31%).

IBA alone was successful in 10 patients.

Stenting way needed in the remaining 3 patients.

Distal bypass grafting was performed'with an autogenous vein conduit in 10 patients.

PTFE placed in the above-knee popliteal segment was used in 3 patients.

The primary patency of combined procedures at 1-year was 81.8%.

There was only one amputation with an overall limb salvage rate of 90.9%.

Conclusion: Iliac angioplasy can successfully be used as a prelude to distal arterial bypass in patients with multilevel atherosclerotic disease.