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Review of direct anatomical open surgical management of atherosclerotic aorto-iliac occlusive disease.

Chiu, K W H and Davies, R S M and Nightingale, P G and Bradbury, A W and Adam, D J (2010) Review of direct anatomical open surgical management of atherosclerotic aorto-iliac occlusive disease. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 39 (4). pp. 460-71. ISSN 1532-2165.

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Abstract

BACKGROUND

Aortofemoral bypass(AFB), iliofemoral bypass(IFB), and aortoiliac endarterectomy(AIE) are the three most common techniques for anatomical open surgical revascularisation for patients with aorto-iliac occlusive disease(AIOD), but the optimal method of reconstruction is unknown.

AIMS

To review and compare mortality, morbidity and short- and long-term patency rates for AFB, IFB and AIE in patients with AIOD reported in the English language literature

METHODS

A MEDLINE(1970-2007) and Cochrane Library search for articles relating to AFB, IFB, AIE and AIOD was undertaken. Studies were included if: a) patency rates based on life-tables were available, and b) patient/study characteristics were reported.

RESULTS

29 studies(5738 patients) for AFB, 11 studies(778 patients) for IFB and 11 studies(1490 patients) for AIE were included. Operative mortality was 4.1% for AFB, 2.7% for IFB and 2.7% for AIE (p<0.0001). Systemic morbidity was 16.0% for AFB, 18.9% for IFB and 12.5% for AIE (p<0.05). Overall 5-year primary patency rates were 86.3%, 85.3% and 88.3% for AFB, IFB and AIE, respectively (p=NS).

CONCLUSION

Aorto-iliac endarterectomy was associated with significantly lower peri-operative morbidity and mortality rates compared with bypass grafting. All three techniques were equally effective in terms of long-term patency.

Item Type: Article
Subjects: WG Cardiovascular system. Cardiology
WO Surgery
Divisions: Planned IP Care > Vascular
Related URLs:
Depositing User: Preeti Puligari
Date Deposited: 05 Jun 2014 09:35
Last Modified: 05 Jun 2014 09:35
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/214

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