Commentary: endovascular therapy should be the first line of treatment in patients with severe (TASC II C or D) aortoiliac occlusive disease.

摘要

In this issue of the JEVT, Sixt et al. present the largest consecutive patient series of percutaneous aortoiliac interventions to date for treatment of symptomatic chronic aortoiliac occlusive disease (AIOD). The current report is a follow-up to their previous study, including more patients and those with occlusions extending to the aorta. Thus, the current cohort represents all-comers who underwent percutaneous revascularizations for AIOD during the study period (1996-2006). They found comparable patency rates in patients with TransAtlantic Inter-Society Consensus II (TASC) A or B disease and those with TASC C or D lesions, which were also comparable to the historic outcomes of direct revascularization. The authors concluded that the indication for percutaneous intervention in AIOD can be extended to complex TASC C and D lesions in experienced endovascular centers, even if complex reconstruction of the distal aorta or the aortic bifurcation is indicated.