Long Term Results Of Aortofemoral Bypass And Percutaneous Translu-minal Angioplasty For Transatlantic Inter-society Type C And Daorto-iliac Occlusive Disease

Objective:To compare the effect of percutaneous transl-uminal angioplastyand aortofemoral bypass graft for treating aortoiliac occlusive disease(TASC C D). Backgrou-nd：The traditional treatment method of aortoiliac occlusive disease is aortofemoral graft byp-ass, percutaneous transluminal angioplasty is used more and more widely, however,the widel-y application of this technique is also based on the long-term patency rate and clinical effect.Methods：From April2008and April2012，there are208patients with aortoiliac occlusivedisease accepted treatment in our department totally.77patients were choosen from these pati-ents randomly.42patients of them under-went aortofemoral bypass grafts(bypass group),incl-uded15patients underwent unilateral aortofemoral bypass grafts,27patients underwent hiba-teral aortofeoral bypass.35patients of them underwent percutaneous transluminal angioplasty(endouvascular group,46iliac arteries totally). They were followed up3years.Results:7patie-nts were lost to follow-up in77patients,follow-up rate was90．9％.70patients had complete-d follow-up of3-36months(mean31．7±2．4months). The3-year primary patency rate and3-year secondary patency rate of bypass group was92.1%and94.7%in bypass group respecti-vely.The3-year primary patency rate and3-year secondary patency rate of endouvascular gr-oup was68.8%and78.1%respectively.The patency rate of these two group have a meaningf-ul different(P﹤0.05).The3-year primary patency rate of bypass group and endovascular gro-up was94.7and75.0%in TASC C patients respectively,with a meaningful different(P﹤0.05).The3-year secondary patency rate of bypass group and endovascular group was94.7and83.3%in TASC C patient-s respectively,without a meaningful different(P＞0.05). The3 -year secondary patency rate of bypass group and endovascular group was89.4%and50.0%in TASC D patients respectively,with a meaningful different (P﹤0.05).The3-year primary pa-tency rate of bypass group and endovascular group was94.7%and62.5%in TASC D patient-s respectively,with a meaningful different (P﹤0.05).Conclusions:TASC C and D lesions canbe treated with either aortofemoral bypass graft or percutaneous transluminal angioplasty withsatisfactory results.Compared with aortofemoral bypass graft, percutaneous transluminal angi-oplasty is associated with decreased long tem patency．aortofemoral bypass should be the fir-st choice for patients without contraindication of aortofemoral bypass.