Background
Infrarenal aortic occlusion (IAO) is a complete occlusion of infrarenal aorta, which is the most complicated and severe subclass of aortoiliac occlusive disease(AIOD). The first-line treatment for IAO is bypass surgery due to its favorable patency rate. As endovascular technique advances, several retrospective studies have reported their endovascular experience for IAO. However, whether endovascular treatment(EVT) is comparable to bypass surgery for IAO required further study. This research was to study the safety and efficacy of EVT for IAO compared to bypass surgery.
Methods
From 2003 to 2017, 44 consecutive patients with IAO was treated with EVT(n=16) or aortofemoral bypass surgery(n=28). The therapeutic strategy depended on patientâs will and state of health. Demographics, comorbidity, mortality, complication rate, and symptom-free survival proportion was compared by T-tests or chi-square test, to illustrate the safety and efficacy of EVT and bypass surgery.
Results
The demographics and pre-operative Rutherford classification equally distributed in the two groups(P>0.05). As for technical success, comorbidities, mortality, complication rate, and Rutherford classification after procedures, clinical success, no significant difference was observed(P>0.05). The median post-procedure hospital stay was 4 days in the EVT group and was significantly shorter than that of the bypass, which was 11 days(P<0.05). As for short-term and long-term results, the 1-year, 3-year, and 5-year the cumulative symptom-free survival rates were 85.7%, 85.7% and 85.7% in the EVT group, 100%, 94.1% and 80.7% in the aortofemoral bypass group. There was no significant difference in symptom-free survival rate between the two groups according to log-rank test (P=0.92)
Conclusions
The safety and efficacy of EVT were comparable to that of anatomic bypass surgery for IAO. EVT could be a feasible option for IAO.