Comparison of Mid-term Results of Surgical and Endovascular Treatment for TASC C & D Lesions of the Iliac Artery

ABSTRACT

PURPOSE: In order to establish therapeutic guidelines for TASC C & D iliac lesions, we compared outcomes of surgical and endovascular treatment. METHODS: From May 2002 to April 2007, 27 limbs of 18 patients underwent bypass operation and 23 limbs of 21 patients underwent stent placement for TASC C & D iliac lesions at Dongsan Medical Center. Age, sex, risk factor, combined diseases, clinical symptoms, treatment method, and patency rate were reviewed retrospectively. RESULTS: Technical and clinical success was achieved in all patients of the bypass group and in 95.8% of patients in the stent group. There were no complications in the surgical group, but 4 major complications in the stent group: 3 distal embolizations, and 1 arterial rupture. The primary patency rates at 6 months, 1, 2, and 3 years were all 90% in the bypass group and 95%, 89%, 89%, and 89%, respectively, in the stent group (P=0.99). The respective secondary patency rates were all 90% in the bypass group and 100%, 94%, 94%, and 94% in the stent group (P=0.56). CONCLUSION: Arterial bypass and stent placement are technically safe and effective treatment modalities in TASC C & D lesions of the iliac artery. A liberal posture to open arterial reconstruction extends the ability to treat diffuse TASC C & D lesions via endovascular means.