Comparative Results of Angioplasty and Aortofemoral Bypass in Patients With Symptomatic Iliac Disease

• Advantages and limitations of percutaneous transluminal angioplasty (PTA) and aortofemoral bypass (AFB) performed for the treatment of iliac atherosclerosis were retrospectively studied in 61 patients who presented over a four-year period. Technical success was achieved in 92% and symptoms initially relieved in 80% of 25 patients who underwent 31 PTA procedures for iliac stenosis or occlusion. Similarly, 92% (33/36) of patients treated with AFP improved clinically. There were no operative deaths in either group or significant difference in the rate of major complications. During the follow-up period, symptoms recurred in nine PTA patients (36%) due to progressive (five patients) or recurrent (four patients) disease within the iliac vessels. Late failure of AFB (8%) was significantly less frequent. While both PTA and AFB provide satisfactory initial relief of ischemic symptoms due to iliac atherosclerosis, long-term results of PTA are limited by progressive or recurrent disease in the iliac vessels.

(Arch Surg 1987;122:288-291)