Aorto Iliac
Endovascular Treatment
Progress in endovascular surgery has resulted in a continuedshift in the treatment of patients with aortoiliac occlusive disease to less invasive forms of therapy.
Patients with hip, buttock, thigh, or calf claudication constitute the largest group of patients who undergo aortoiliac endovascular revascularization.
Patient-specific indications for aortoiliac intervention treatment include lifestyle-limiting claudication, rest pain, and tissue loss. Patients with critical limb Ischemia (CLI) manifesting as either rest pain or tissue loss frequently have multilevel occlusive disease.
Lesion-specific indications for the endovascular therapy of aortoiliac occlusive disease can be guided by the Trans-Atlantic Inter-Society Consensus (TASC) guidelines.
Evaluation for Common Femoral Artery Disease and Concomitant Aortic Disease are usually treated with a hybrid approach that entails open femoral endarterectomy, patch angioplasty, and simultaneous stent or stent-graft placement.
Percutaneous Transluminal Angioplasty(PTA) of focal iliac artery stenoses has demonstrated acceptable success rates.
Nearly half the patients(43%) treated by balloon angioplasty underwent stent placement for a suboptimal result during the primary procedure.
Stent-grafting has been used to treat patients with severe aortoiliac occlusive disease, especially those with small, calcified EIAs, who are not candidates for open surgical intervention.
POSTOPERATIVE MANAGEMENT:
In general, all patients should receive antiplatelet therapy and a statin. Regular follow-up should be performed at 1 month, 6 months, and yearly to assess patient outcome.