Key result
Aorto-uni-iliac endovascular aortic repair without femorofemoral crossover achieved 85% technical success compared to 97% with crossover (P=0.31), with no postoperative critical lower limb ischemia.
Why the study?
Does AUI EVAR without femorofemoral crossover provide similar safety and efficacy to AUI EVAR with crossover in patients with AAA and aortoiliac occlusive disease?
Observational (n=40)
No
Does AUI EVAR without femorofemoral crossover provide similar safety and efficacy to AUI EVAR with crossover in patients with AAA and aortoiliac occlusive disease?
Absolute Event Rate: 85% vs 97%
p-value: p=0.31
AUI EVAR without crossover bypass appears to be a viable and safe option in selected patients with AAA and total occlusion of one iliac axis.
May support AUI EVAR without crossover in select AAA patients; leaves open need for larger studies.
We investigated the safety and efficacy of primary aorto-uni-iliac (AUI) endovascular aortic repair (EVAR) without fem-fem crossover in patients with abdominal aortic aneurysm (AAA) and concomitant aortoiliac occlusive disease. 537 EVARs were implemented between 2002 and 2015 in University Hospital Galway, a tertiary referral center for aortic surgery and EVAR. We executed a parallel observational comparative study between 34 patients with AUI with femorofemoral crossover (group A) and six patients treated with AUI but without the crossover (group B). Group B patients presented with infrarenal AAAs with associated total occlusion of one iliac axis and high comorbidities. Technical success was 97% (n = 33) in group A and 85% (n = 5) in group B (P = 0.31). Primary and assisted clinical success at 24 months were 88% (n = 30) and 12% (n = 4), respectively, in group A, and 85% (n = 5) and 15% (n = 1), respectively, in group B (P = 0.125). Reintervention rate was 10% (n = 3) in group A and 0% in group B (P = 0.084). No incidence of postoperative critical lower limb ischemia or amputations occurred in the follow-up period. AUI without crossover bypass is a viable option in selected cases.
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Elkassaby et al. (2015) conducted an observational in Abdominal aortic aneurysm (AAA) and concomitant aortoiliac occlusive disease (n=40). Aorto-uni-iliac (AUI) endovascular aortic repair without femorofemoral crossover vs. Aorto-uni-iliac (AUI) endovascular aortic repair with femorofemoral crossover was evaluated on Technical success (p=0.31). Aorto-uni-iliac endovascular aortic repair without femorofemoral crossover achieved 85% technical success compared to 97% with crossover (P=0.31), with no postoperative critical lower limb ischemia.
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