Comparative Results of Angioplasty and Aortofemoral Bypass in Patients With Symptomatic Iliac Disease

Advantages and limitations of percutaneous transluminal angioplasty (PTA) and aortofemoral bypass (AFB) performed for the treatment of iliac atherosclerosis were retrospectively studied in 61 patients who presented over a four-year period. Technical success was achieved in 92% and symptoms initially relieved in 80% of 25 patients who underwent 31 PTA procedures for iliac stenosis or occlusion. Similarly, 92% (33/36) of patients treated with AFP improved clinically. There were no operative deaths in either group or significant difference in the rate of major complications. During the follow-up period, symptoms recurred in nine PTA patients (36%) due to progressive (five patients) or recurrent (four patients) disease within the iliac vessels. Late failure of AFB (8%) was significantly less frequent. While both PTA and AFB provide satisfactory initial relief of ischemic symptoms due to iliac atherosclerosis, long-term results of PTA are limited by progressive or recurrent disease in the iliac vessels.