Open Surgery versus Hybrid Endovascular Treatment for Infrarenal Aortoiliac Occlusive Disease

Won-min Jo, Jinwook Hwang, Jae Seung Shin

ANSAN HOSPITAL, KOREA UNIVERSITY MEDICAL CENTER, GYEONGGI-DO, Korea (South)

Date, time and location: 2018.05.26 13:30, Congress Hall, 2F–A

Abstract

Objectives The aim of this study was to compare the clinical results of open surgery (aortobiiliac bypass) versus hybrid endovascular treatment (non-laparotomy surgery with endovascular intervention) for infrarenal aortoiliac occlusive disease, retrospectively. Methods From January 2010 to December 2016, total 95 patients were enrolled. Open surgery was performed in 46 patients (group 1) and in the remaining 49, a hybrid endovascular treatment was carried out (group 2). Mean follow up period is 39.7± 31.2 months. The patency rates and limb salvage rates for extensive aortoiliac occlusive (TASC C & D) patients were analyzed with Kaplan-Meier curves and compared with log-rank test. Results Patients were more frequent in male (group 1 ; 91.8%, group 2 ; 82.6%) and mean age was 69.76± 9.29 years. There’s no statistical differences in demographics. The most common risk factors were arterial hypertension (76.8%) and smoking (63.2%), and symptoms were claudication (68.4%), rest pain (25.3%) and tissue loss (14.7%) in both groups. There was no patient required immediate conversion to laparotomy surgery. There was one perioperative death in group 1 (mortality rate, 2.2%) and no perioperative death in group 2. The 1-year and 3-year primary patency rates showed 97.8% and 82.4% in group 1, and 87.0% and 75.5% in group 2. This revealed the statistical significance (p = .013) However, the 1- and 3-year limb salvage rates for extensive aortoiliac occlusive (TASC C&D) patients did not show the significant difference statistically (group 1 ; 100% and 90.6%, group 2 ; 100% and 74.6%, p=.182). Conclusions Although our study showed the inferiority of primary patency rate in hybrid endovascular treatment, limb salvage rates were not different significantly in both groups. Therefore, non-laparotomy surgery with endovascular intervention treatment could be a good alternative treatment for selected patients who had high risks for laparotomy surgery.