Iliac artery stenting combined with open femoral endarterectomy is as effective as open surgical reconstruction for severe iliac and common XXXX .

@entity1 @entity8625 @entity432
PURPOSE: To compare outcomes of @entity8625 ( @entity8625 ) combining iliac artery stenting and open common femoral endarterectomy (CFE) with open aortoiliac and femoral reconstruction (OR) in @entity1 with extensive iliac and common @entity432 (IFOD). METHODS: Between 1998 and 2008, 92 @entity1 (164 limbs) underwent OR and 70 (84 limbs) underwent @entity8625 . All @entity1 underwent concomitant CFE. Thirty-day mortality and morbidity, long-term patency, procedurally related limb salvage, and overall survival were analyzed after stratification by iliac TransAtlantic InterSociety Consensus (TASC) classification into TASC A/B and TASC C/D. RESULTS: @entity8625 @entity1 were older for both TASC groups (A/B, P = .02; C/D, P = .01) and had higher Society for Vascular Surgery (SVS) cardiac comorbidity scores (A/B, P = .01; C/D, P < .001) compared with OR. Technical success was >= 99% in both groups. An increase in the ankle-brachial index after the procedure was significantly higher in OR @entity1 (0.49    0.28) with TASC A/B lesions than @entity8625 (0.22    0.18, P = .031). Hospital and intensive care unit (ICU) lengths of stay were 3.9 days for @entity8625 @entity1 in TASC C/D vs 9.4 days for OR @entity1 (P = .005). Comparing @entity8625 and OR, 30-day morbidity (3% vs 5%, P = .55) and mortality (1.1% vs 1.4%, P = .85) were equivalent. Primary patency of @entity8625 vs OR at 3 years was similar (91% vs 97%, P = .29) and was maintained after stratification by TASC A/B (89% vs 100%, P = .38) and TASC C/D (95% vs 97%, P = .54). Multivariate analysis for patency indicated that major tissue loss (Rutherford class 6) at presentation in the @entity8625 group was predictive of decreased long-term patency (P = .02). Limb salvage at 3 years was 100% in both groups. Overall survival was 74% for OR vs 40% for @entity8625 (P = .007). CONCLUSION: IFOD can be treated using @entity8625 with similar early and long-term efficacy vs OR. @entity8625 @entity1 with TASC C/D lesions experienced a shorter ICU and hospital stay than OR @entity1 . @entity8625 should be considered for all @entity1 with IFOD regardless the severity of TASC classification, particularly in those with high surgical risk. When deciding between @entity8625 and OR, one must consider that major tissue loss at presentation is a negative predictor of long-term patency in @entity1 undergoing @entity8625 .
