REVIEWS  NEW DEVELOPMENTS IN THE TREATMENT OF COMPLEX LOWER EXTREMITY LESIONS 

The Journal of Cardiovascular Surgery 2015 February;56(1):73-9

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: English

Treatment of the aorto-iliac segment in complex lower extremity arterial occlusive disease

Wressnegger A., Kinstner C., Funovics M. ✉

Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image‑Guided Therapy, Medical University of Vienna, Vienna, Austria

Endovascular treatment of the aortoiliac segment in occlusive disease has an established role especially in TASC A and B lesions. Recent studies with modern stent technology have shown excellent results with one-year primary patency above 95%. Regarding different endovascular approaches, there is level Ib evidence supporting provisional stenting in stenosed arteries, and primary stenting in occlusion. While open surgery shows higher patency rates in direct comparison to endovascular techniques, the latter show significantly lower complication rates and lower mortality. The recommendations reserving TASC C and D lesions exclusively to surgery are currently challenged, especially in poor surgical candidates.