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J Endovasc Ther 2021 Jun 23:15266028211025028. Epub 2021 Jun 23.

Department of Vascular Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.

Objective: This UK multicenter study aims to report early- and medium-term results following covered endovascular reconstruction of aortic bifurcation (CERAB) for the treatment of aortoiliac occlusive disease (AIOD) in patients with chronic limb threatening ischemia (CLTI) or intermittent claudication (IC).

Materials And Methods: Retrospective case analysis was performed of patients who underwent CERAB between November 1, 2012 and March 31, 2020 in 6 centers across the United Kingdom. Anatomical data, including degree of plaque calcification, were assessed using preoperative imaging. Read More

Radiol Case Rep 2021 Aug 8;16(8):1993-1998. Epub 2021 Jun 8.

Radiology Department, UCSI Hospital, Negeri Sembilan, Malaysia.

Aortoilliac occlusive disease is occlusive atherosclerosis disease involving the distal aorta and bifurcation of iliac arteries and it is a subtype of peripheral arterial disease. Total occlusion of the abdominal aorta is a rare occurrence with an incidence of 3% -8.5% among the aortoiliac occlusive disease patients. Read More

Vascular 2021 Jun 10:17085381211023229. Epub 2021 Jun 10.

Office of Healthcare-Associated Infection Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji'nan, China.

Purpose: To evaluate the safety and efficacy of transbrachial and transfemoral approaches combined with visceral protection for the endovascular treatment of juxtarenal aortoiliac occlusive disease (AIOD) over an average 19-month follow-up period.

Methods: In this retrospective analysis, all patients with juxtarenal AIOD at a single institution were reviewed from June 2015 to January 2020. Patient characteristics, angiographic results, and follow-up outcomes were retrospectively recorded. Read More

J Endovasc Ther 2021 Jun 2:15266028211016431. Epub 2021 Jun 2.

Multi-Modality Medical Imaging (M3I) Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands.

Purpose: To compare the flow patterns and hemodynamics of the AFX stent-graft and the covered endovascular reconstruction of aortic bifurcation (CERAB) configuration using laser particle image velocimetry (PIV) experiments.

Materials And Methods: Two anatomically realistic aortoiliac phantoms were constructed using polydimethylsiloxane polymer. An AFX stent-graft with a transparent cover made with a new method was inserted into one phantom. Read More

Medicina (Kaunas) 2021 May 12;57(5). Epub 2021 May 12.

Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Korea.

Introduction: Leriche syndrome is an aortoiliac occlusive disease caused by atherosclerotic occlusion. We report a case of Leriche syndrome with a fracture that was suspected as complex regional pain syndrome (CRPS), as the post-traumatic pain gradually worsened in the form of excruciating neuropathic pain.

Case Report: A 52-year-old woman with a history of hypertension was referred to the Department of Pain Medicine from a local orthopedic clinic because of suspected CRPS for excruciating neuropathic pain for one month. Read More

J Vasc Surg Cases Innov Tech 2021 Jun 28;7(2):277-279. Epub 2021 Jan 28.

Division of Vascular and Endovascular Surgery, Louisiana State University Health Sciences Center, New Orleans, La.

Although the use of aortoiliac endarterectomy to treat occlusive disease has declined since the advent of endovascular procedures and operative bypass grafting techniques, clinical scenarios still exist in which it can be useful. We present the case of a patient with right lower extremity pain at rest, an anomalous right pelvic kidney, right common iliac artery occlusion, and severe left common iliac artery stenosis. We have demonstrated that aortoiliac endarterectomy should not be considered an outdated surgical technique but a viable alternative for revascularization in a specific subset of patients. Read More

BMC Cardiovasc Disord 2021 Apr 30;21(1):220. Epub 2021 Apr 30.

Centre for Research and Development, Uppsala University/Region Gävleborg, 801 87, Gävle, Sweden.

Background: Leriche syndrome is the triad of symptoms consisting of claudication, erectile dysfunction, and absence of femoral pulses. Inflammatory disease of the heart muscle, myocarditis, may occur because of immune system activation, drug exposure or infections.

Case Presentation: A 31-year-old man with no previous medical history presented to the emergency department with acute back pain that had started suddenly during weightlifting, which was initially misdiagnosed as spinal disc herniation. Read More

Vasc Endovascular Surg 2021 Apr 27:15385744211010381. Epub 2021 Apr 27.

Division of Cardiology, Rocky Mountain Regional VA Medical Center, University of Colorado, Denver, CO, USA.

Purpose: The treatment of aortoiliac occlusive disease (AIOD) has largely shifted to endovascular techniques, with primary stenting constituting the preferred treatment approach. The goal of the current study was to summarize available literature and to determine whether covered stents are superior to bare metal stents for the treatment of AIOD, in terms of both periprocedural and long-term outcomes.

Methods: A meta-analysis of 47 studies was conducted with the use of random effects modeling. Read More

Ann Vasc Surg 2021 Apr 5. Epub 2021 Apr 5.

Department of Surgery, Divisions of Vascular, VA Boston Healthcare System, West Roxbury, Massachusetts. Electronic address:

Despite its relative underutilization in the primary management of aortoiliac occlusive disease, thoracofemoral bypass is an attractive extra-anatomic surgical option in select patients. Thoracofemoral bypass classically entails passing a graft from the left chest into the retroperitoneal space through a small opening created in the diaphragm. While theoretically possible that this maneuver may predispose to a peri-graft diaphragmatic hernia, currently there are no cases of this complication reported in the literature, nor has its surgical repair been described. Read More

Quant Imaging Med Surg 2021 Apr;11(4):1303-1312

Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China.

Background: Open surgery is the gold standard for the treatment of aortoiliac occlusive disease (AIOD). Endovascular therapy has emerged as an attractive alternative for AIOD due to its minimal invasiveness. The aims of the present study were to investigate the long-term patency of endovascular treatment and to compare the outcomes of Transatlantic Inter-Society Consensus II (TASC II) A/B and C/D lesions. Read More

J Phys Ther Sci 2021 Mar 17;33(3):261-266. Epub 2021 Mar 17.

Department of General Surgery, Kawasaki Medical School General Medical Center, Japan.

[Purpose] To examine the differences in rehabilitation progress after lower-extremity bypass surgery for peripheral arterial disease (PAD) depending on the occlusive lesions. [Participants and Methods] This was a retrospective study. We included 50 patients (61 limbs; 38 males and 12 females; mean age, 73 years) who underwent lower-extremity bypass surgery for Fontaine stage 2-3 PAD. Read More

J Vasc Surg 2021 Feb 3. Epub 2021 Feb 3.

Division of Vascular and Endovascular Surgery, Department of Surgery, University of Virginia, Charlottesville, Va. Electronic address:

Objective: Despite advancements, aortofemoral bypass (AFB) remains the most durable option for aortoiliac occlusive disease. Although runoff has been shown to be associated with AFB patency, the association of the Society for Vascular Surgery (SVS) thigh runoff scoring system with patency has not been assessed. The aim of the present study was to evaluate the association between the SVS runoff scoring system and limb-based primary patency after AFB. Read More

Angiology 2021 Aug 5;72(7):640-650. Epub 2021 Feb 5.

Department of Cardiology, 448249University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey.

We report the results of endovascular treatment of Trans-Atlantic Inter-Society Consensus II (TASC) A&B, TASC C, and TASC D aortoiliac lesions in a single vascular center. In this retrospective, observational cohort study, we analyzed 395 patients (mean age 61.2 ± 9. Read More

Eur Heart J Case Rep 2020 Dec 24;4(6):1-6. Epub 2020 Nov 24.

Department of Interventional Cardiology, Galway Clinic, Royal College of Surgeons in Ireland Affiliated Hospitals, Doughiska, Galway H91 HHT0, Ireland.

Background: Transcarotid transcatheter aortic valve implantation (TAVI) is a worthwhile substitute in patients who might otherwise be inoperable; however, it is applied in <10% of TAVI cases. In patients with established carotid artery stenosis, the risk of complications is increased with the transcarotid access route.

Case Summary: We report a case of concomitant transcarotid TAVI and carotid endarterectomy (CEA) in a patient with bovine aortic arch and previous complex infrarenal EndoVascular Aortic Repair (EVAR). Read More

Turk Gogus Kalp Damar Cerrahisi Derg 2020 Oct 21;28(4):615-622. Epub 2020 Oct 21.

Department of Phisiology and Surgery, Faculdade de Medicina da Universidade do Porto, Portugal.

Background: This study aims to validate the psoas muscle area and psoas muscle density as morphometric predictors in cardiovascular and cerebrovascular endpoints in patients with extensive aortoiliac peripheral arterial disease.

Methods: A total of 57 patients (55 males, 2 females; mean age 60±8.2 years; range, 35 to 83 years) with Trans-Atlantic Inter-Society Consensus type D lesions who underwent revascularization at two Portuguese tertiary hospitals between January 2013 and July 2019 were retrospectively analyzed. Read More

J Vasc Surg Cases Innov Tech 2020 Sep 26;6(3):425-429. Epub 2020 Jun 26.

University of California, Riverside School of Medicine, Riverside, Calif.

Accessory renal arteries (ARAs) are embryonic remnants found in more than one-third of patients and occurring bilaterally in 10% of the population. Very few reports have documented such vessels arising near or at the level of the aortic bifurcation. Furthermore, the presence of ARAs has yet to be described in the context of atherosclerotic disease. Read More

Vasc Specialist Int 2020 Dec;36(4):216-223

Department of Vascular and Endovascular Surgery, Western Vascular Institute, Galway University Hospital, Galway, Ireland.

Purpose: We compared the outcomes between the total endovascular approach using a unibody bifurcated aortoiliac endograft and the gold standard aortobifemoral bypass (ABF) surgery for the management of extensive aortoiliac occlusive disease (AIOD).

Materials And Methods: This retrospective observational study compared the outcomes of endovascular technique with unibody bifurcated endograft (UBE) using the Endologix AFX unibody stent-graft and a standard surgical approach (ABF) in the management of AIOD based on patient records in Western Vascular Institute, Galway University Hospital, National University of Ireland. Procedural details and outcomes were documented to compare both groups. Read More

J Vasc Surg 2021 Jun 16;73(6):1991-1997.e3. Epub 2020 Dec 16.

Division of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, Ala. Electronic address:

Objective: Thoracofemoral bypass (TFB) has been used infrequently but is an alternative for select patients with aortoiliac occlusive disease. Limited data are available in the reported data regarding TFB, with all studies small, single-center series. We aimed to describe the perioperative and long-term survival, patency, and rate of major perioperative complications after TFB in a large national registry. Read More

Ann Vasc Surg 2021 Apr 15;72:668.e5-668.e8. Epub 2021 Jan 15.

Department of Vascular Surgery, Royal North Shore Hospital, St Leonards, Australia.

Radiation-induced arteritis is a well-recognized complication of radiotherapy; however, radiation-induced venous stenosis is very rare (Zhou W, Bush RL, Lin PH, et al. Radiation-associated venous stenosis: endovascular treatment options. J Vasc Surg 2004;40:179-182). Read More

Ned Tijdschr Geneeskd 2020 12 2;164. Epub 2020 Dec 2.

Amphia Ziekenhuis, afd. Chirurgie,Breda.

Leriche syndrome was diagnosed in three patients aged 63, 71 and 73. They presented with a wide range of neurological symptoms such as impotence, pain or dysfunction of the lower extremities. Because a neurological diagnosis was initially suspected, there was a delay in two of the three patients before palpation for a distal pulse in the lower extremities was performed. Read More

Chin Med J (Engl) 2020 Dec 8;134(8):913-919. Epub 2020 Dec 8.

Institute of Vascular Surgery, Department of Vascular Surgery, Zhongshan Hospital, Fudan University; Center for Vascular Surgery and Wound Care, Jinshan Hospital, Fudan University, Shanghai 201508, China.

Background: Although endovascular therapy has been widely used for focal aortoiliac occlusive disease (AIOD), its performance for extensive AIOD (EAIOD) is not fully evaluated. We aimed to demonstrate the long-term results of EAIOD treated by endovascular therapy and to identify the potential risk factors for the loss of primary patency.

Methods: Between January 2008 and June 2018, patients with a clinical diagnosis of the 2007 TransAtlantic Inter-Society Consensus II (TASC II) C and D AIOD lesions who underwent endovascular treatment in our institution were enrolled. Read More

Aorta (Stamford) 2020 Aug 11;8(4):116-117. Epub 2020 Dec 11.

Department of Anatomy, Medical School of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.

This report describes the collateral pathways that restore arterial circulation in cases of aortoiliac occlusive disease and discusses the clinical and surgical importance of these systemic-systemic, visceral-systemic, and visceral-visceral anastomoses. Read More

Indian J Radiol Imaging 2020 Jul-Sep;30(3):405-408. Epub 2020 Oct 15.

Department of Radiodiagnosis, Yashoda Hospitals, Somajiguda, Raj Bhavan Road, Hyderabad, Telangana, India.

As the initial treatment of patients with the iliac occlusive disease, percutaneous transluminal angioplasty (PTA) became common. Though not supported by the latest TransAtlantic Inter-Society Consensus (TASC) II guidelines, percutaneous treatment of complex aortoiliac lesions is possible and provides comparable angiographic and clinical outcomes compared to open surgery at both short- and long-term follow-up, also in complex lesion settings. TASC C and D lesions with the latest instruments, procedures, and modalities may also be managed endovascularly. Read More

Interact Cardiovasc Thorac Surg 2021 01;32(1):83-88

Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China.

Objectives: This study was undertaken to evaluate the acute and midterm results of endovascular treatment with bare metal stents (BMS) for Leriche syndrome patients.

Methods: Patients with Leriche syndrome treated with BMS from August 2008 to May 2017 were included in the study and followed up. The primary endpoints were primary restenosis-free survival rates at 1, 2 and 3 years. Read More

J Vasc Surg 2021 01 17;73(1):18-21. Epub 2020 Oct 17.

Vascular Surgery, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France; Université Claude Bernard Lyon 1, Faculté de Médecine Rockefeller, Lyon, France.

The severe acute respiratory syndrome novel coronavirus-2 pandemic is affecting almost every country in the world. Even if the major symptoms of coronavirus disease-2019 are respiratory, different symptoms at presentation are now recognized. Venous thromboembolism has been reported in infected patients and few but increasing cases of arterial thrombosis have been described. Read More

Rev Port Cir Cardiotorac Vasc 2020 Jul-Sep;27(3):231-233

Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal; Department of Angiology and Vascular Surgery, Centro Hospitalar Vila Nova de Gaia/ Espinho, Vila Nova de Gaia, Portugal.

Aortoiliac occlusive disease (AIOD) remains an area of debate concerning open and endovascular treatment options. A case of a 63-year old female is reported, with previous known vascular intermittent claudication, that presented in the emergency room with acute ischemia of the right lower limb with 24-hours of evolution. The computer tomographic angiography unveiled occlusion of the superior mesenteric artery, occlusion of left common iliac artery (CIA), subocclusive stenosis of right CIA, occlusion of distal runoffs vessels in the right lower limb and diffuse aorto-iliac disease. Read More

Front Cardiovasc Med 2020 25;7:144. Epub 2020 Aug 25.

Assistance Publique - Hôpitaux de Paris (AP-HP), Service d'Imagerie Médicale, CHU Henri Mondor, Créteil, France.

Endovascular approach is the first-choice treatment in patients suffering from aortoiliac occlusions. Nevertheless, standard endoluminal revascularization fails in treating occlusions in about 20% (1) of cases. Thus, subintimal revascularization can be a solution, but it fails in 25% (2) of cases as well. Read More

BMC Neurol 2020 Oct 8;20(1):369. Epub 2020 Oct 8.

Department of Neurology, Nordland Hospital, 8092, Bodø, Norway.

Background: Room tilt illusion (RTI) is a rare symptom of higher vestibular dysfunction, consisting of a transient vertical rotation of the visual scene in the sagittal or coronal plane, most often 90 or 180, without any alteration in shape, size and color of objects.

Case Presentation: A 63-year-old woman with a history of hypertension and chronic obstructive pulmonary disease went through an uncomplicated aortobifemoral graft surgery due to aortoiliac occlusive disease. Post-operatively she experienced five episodes, lasting from 10 to 30 min, with RTI; 90 forward rotation of the visual scene in the sagittal plane. Read More

J Vasc Surg 2020 10;72(4):1427-1435.e1

Division of Vascular Surgery, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa. Electronic address:

Objective: This study aimed to develop risk predictive models of 30-day mortality, morbidity, and major adverse limb events (MALE) after bypass surgery for aortoiliac occlusive disease (AIOD) and to compare their performances with a 5-Factor Frailty Index.

Methods: The American College of Surgeons National Surgical Quality Improvement Program 2012-2017 Procedure Targeted Aortoiliac (Open) Participant Use Data Files were queried to identify all patients who had elective bypass for AIOD: femorofemoral bypass, aortofemoral bypass, and axillofemoral bypass (AXB). Outcomes assessed included mortality, major morbidity, and MALE within 30 days postoperatively. Read More

Ann Vasc Surg 2021 Feb 11;71:84-95. Epub 2020 Sep 11.

Division of Vascular and Endovascular Surgery, Department of Cardiac Thoracic and Vascular Sciences, University of Padova, Padova, Italy; Division of Vascular and Endovascular Surgery, Cardiovascular Department, University of Trieste Medical School, Trieste, Italy. Electronic address:

Background: To compare endovascular therapy (EVT) using kissing self-expanding covered stents, with open repair (OR) with aortobifemoral bypass (ABF), for reconstruction of the aortic bifurcation in Trans-Atlantic Inter-Society Consensus II (TASC-II) C/D aortoiliac occlusive disease (AIOD).

Methods: A single-center retrospective analysis of patients treated by EVT or ABF for TASC-II C/D AIOD (2009-2018) was carried out. The perioperative risk was quantified by the Society for Vascular Surgery (SVS) and American Society of Anesthesiologists (ASA) scores. Read More