Key result
Endovascular techniques for severe aorto-iliac lesions achieve ~90% early success, supporting first-line use.
Why the study?
Critical limb ischemia poses a substantial healthcare burden and is often associated with complex aortoiliac lesions in elderly, high-risk patients.
Do endovascular techniques provide favorable success and safety outcomes in elderly and high-risk patients with critical limb ischemia and severe aorto-iliac lesions?
Do endovascular techniques provide favorable success and safety outcomes in elderly and high-risk patients with critical limb ischemia and severe aorto-iliac lesions?
Endovascular techniques demonstrate high success and limb salvage rates with low perioperative mortality, supporting an endovascular-first approach for severe aorto-iliac lesions in high-risk CLI patients.
May support endovascular-first approach in high-risk CLI; extends Level 5 data but leaves open need for randomized confirmation.
With an estimated yearly incidence of 500 to 1000 new cases per million individuals in Western society, critical limb ischemia (CLI) poses a substantial burden on patients, healthcare providers, and resources. In this review article, we noted that CLI represent 22 to 45% of larges series of aortoiliac stenting, even if regularly completed with infraunguinal restorations. CLI is generally associated with the more complexe aortoiliac lesions (TASC C and D lesions), with generally supra and infra-inguinal multilevel occlusive arterial disease, in an elderly and high-risk population. The different endovascular techniques for the treatment of severe aorto-iliac lesions are associate with an early success rate ranging from 86 to 95% depending of TASC classification. Perioperative death and complications are respectively of 0.3% and 6.3%. Midterm patency is obtained in 66 to 75% in case of rest pain, and 75% in case of tissue loss, with a limb salvage rate of respectively of 100% and 73%. These encouraging results lead to choose endovascular technique as a first choice over open surgery, especially in case of major comorbidities in high-risk patients.
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Yves Alimi (2021) conducted a review in Critical limb ischemia (CLI). Endovascular techniques vs. Open surgery was evaluated on Early success rate. Endovascular techniques for severe aorto-iliac lesions in critical limb ischemia achieve early success rates of 86-95% with 0.3% perioperative mortality, supporting their use as a first-line option.
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