Abstract
Long-term results of 191 cases for unilateral iliac artery occlusive disease were retrospectively reviewed. The vascular procedures included 132 aorto- or ilio-femoral (AF) bypasses, 37 femoro-femoral crossover (FF) bypasses, and 22 unilateral axillo-femoral (AxF) bypasses. Operation was performed for claudication in 165 cases and limb salvage in 26 cases. The TASC classification of the iliac artery disease included 6 cases of type B, 17 cases of type C, and 168 cases of type D. Primary patency rates for all cases were 90% and 77% at 5 and 10 years after operation, respectively. In the AF group, there were 56 cases with occluded superficial femoral artery, of which 37 infrainguinal bypasses and 11 profundoplasties were performed simultaneously. During the follow-up periods, an additional infrainguinal bypass was required for 7 cases and repair of anastomotic pseudoaneurysm was preformed for 2 cases. Also, 11 revascularization procedures and one major amputation were performed for contralatral limb ischemia. The 5-year primary patency rate for the AF group was 92%, which was equivalent to that of the FF group (97%) and superior to the AxF group (65%). AF bypass for limb salvage had poor long-term patency. In treating unilateral iliac artery occlusive disease, attention to the ipsilateral infrainguinal artery or the contralateral lower limb artery diseases should be paid to obtain a better outcome, despite the favorable long-term patency rates for AF bypass.
