J Korean Soc Vasc Surg.  2002 Apr;18(1):46-52.

Combined Angioplasty and Femorofemoral Bypass in the Treatment of Unilateral Iliac Arterial Occlusive Disease

Affiliations
  • 1Department of Surgery, Korea University College of Medicine, Seoul, Korea. sijung@ns.kumc.or.kr
  • 2Department of Diagnostic Radiology, Korea University College of Medicine, Seoul, Korea.

Abstract

PURPOSE: The purpose of this article is to analyze the results of combined agioplasity and femorofemoral bypass in patients with unilateral iliac arterial occlusive disease. METHOD: During the 11-year period from 1990 to 2000, 44 patients with iliac artery occlusion and a hemodynamically significant contralateral iliac artery stenosis were treated by using a combination of percutaneous transluminal angioplasity (PTA) and femorofemoral bypass (n=18) as well as aortobifemoral bypass (n=12) and iliofemoral bypass (n=14) at Korea university medical center. PTA was performed if the lesions in the donor iliac artery were less than 3 cm in length with no more than one well-localized lesion in either the common or external iliac artery, or both. Stent was deployed for suboptimal PTAs. The femorofemoral bypass was done within 3 to 5 days after PTA or stenting. RESULT: The mean age was 61.2 years. The Indications of femorofemoral bypass were hypertension, ischemic heart disease, chronic obstructive lung disease, old age (>75), cancer, and previous abdominal operation. The complication rate of the combination treatment was lower than that of the others. Primary patency rate at 1 and 3 years were 89%, 78% for aortobifemoral bypass, 83%, 66% for iliofemoral bypass, and 77%, 65% for femorofemoral bypass, respectively.
CONCLUSION
The combination of PTA with or without stent deployment and femorofemoral bypass can be a useful option for treating iliac occlusion and contralateral iliac stenosis in patients with severe comorbid illness, advanced age, and intra-abdominal pathology. Angioplasity can allow more widespread use of femorofemoral bypass in these patients.

Keyword

Angioplasty; Femorofemoral bypass; Iliac artery; Occlusion

MeSH Terms

Academic Medical Centers
Angioplasty*
Arterial Occlusive Diseases*
Constriction, Pathologic
Humans
Hypertension
Iliac Artery
Korea
Myocardial Ischemia
Pathology
Pulmonary Disease, Chronic Obstructive
Stents
Tissue Donors
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