Abstract
Peripheral arterial disease (PAD) affects over 200 million worldwide and is the leading
cause of major limb amputation, with individuals suffering from PAD being at three
times greater risk of dying compared with matched controls. TASC-II guidelines provide
a consensus on the management of PAD based on the collaboration between international
vascular specialties. These guidelines previously outlined open surgery as the gold
standard for treatment of aortoiliac disease and PAD as it has demonstrated consistent
long-term results. However, this approach is also associated with high perioperative
mortality, especially when compared with endovascular techniques. With recent developments
in endovascular technology, user technique, and experience, this approach has become
more widely used as primary intervention for aortoiliac disease. One of these novel
techniques includes covered endovascular reconstruction of the aortic bifurcation,
which has demonstrated excellent technical success and improved primary and secondary
patency rates with follow-up. The aim of this review is to compare the efficacy of
these approaches to the treatment of aortoiliac disease and demonstrate the benefits
of the shift toward an endovascular-first approach to treatment of this disease, regardless
of lesion complexity or severity.
Keywords
aortoiliac occlusive disease - endovascular - CERAB - iliac artery - aorta - interventional
radiology
