[Endovascular therapy of aorto-iliac occlusive disease].

Abstract

Background: Arterial occlusive disease of the central arteries involving the abdominal aorta and iliac arteries leads to multiple symptoms such as intermittent claudication, including of the gluteus muscle, and erectile dysfunction.

Objectives: A description of the indications, technique and clinical outcomes of the endovascular therapy of aorto-iliac artery occlusive disease.

Results: Due to new endovascular techniques and improved stents and stent grafts developed over the last two decades, the endovascular therapy of aorto-iliac obstructions has become the standard method for the treatment of intermittent claudication in experienced centers. Open surgical bypass revascularisation is mainly indicated after a failed endovascular attempt or in the case of unfavourable anatomy for endovascular therapy, including flush occlusions distal to the renal artery origins. A less frequently used revascularisation technique, the hybrid revascularisation, combines open surgical thromboendarterectomy of the common femoral artery and stent implantation of the ipsilateral iliac artery or aorta. Obstructions of the internal iliac artery resulting in, among other things, erectile dysfunction and hip claudication are ever more frequently treated with either drug-eluting stents or balloons.

Conclusion: In the case of appropriate operator experience and suitable anatomy, endovascular therapy has become the first-line revascularisation strategy for aorto-iliac occlusive disease involving the internal iliac artery.