TY  - JOUR
T1  - OUtcomes of open operation for aortoiliac occlusive disease after failed endovascular therapy
AU  - Danczyk RC, Mitchell EL, Petersen BD, et al
Y1  - 2012/09/01
N1  - 10.1001/archsurg.2012.1649
JO  - Archives of Surgery
SP  - 841
EP  - 845
VL  - 147
IS  - 9
N2  - Objectives 
                  To compare patient outcomes of primary open operation for aortoiliac occlusive disease (AIOD) with those of secondary open operations for failed endovascular therapy (ET) of AIOD.Design 
                  A retrospective cohort study was performed analyzing demographic characteristics, comorbidities, and outcomes.Setting 
                  Affiliated Veterans Affairs Hospital from January 1, 1998, through March 31, 2010.Patients 
                  Patients who underwent primary open operation for AIOD or secondary open operation for failed ET of AIOD.Main Outcome Measures 
                  Overall survival and limb salvage.Results 
                  Primary open operations (n = 153) were 67 aortobifemoral grafts (43.8%), 38 axillobifemoral grafts (24.8%), and 48 femoral-femoral grafts (31.4%). Secondary open operations (n = 35) were 28 aortobifemoral grafts (80.0%), 5 axillobifemoral grafts (14.3%), and 2 femoral-femoral grafts (5.7%). Mean (SD) 5-year survival was 48.2% (5.6%) and 66.8% (10.0%), respectively, for patients undergoing primary vs secondary open surgery for AIOD (P = .01). There were 7 amputations during a mean follow-up of 3 years, all in the primary open surgery group.Conclusions 
                  Despite a higher proportion of coronary artery disease and a 20% conversion of claudication to critical limb ischemia after failed ET for AIOD, survival was longer in patients undergoing secondary vs primary open surgery. Patients who underwent open surgery after failed ET for AIOD did not require amputation. Failed ET for AIOD does not lead to worse outcomes for patients undergoing open surgery for AIOD.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2012.1649
UR  - http://dx.doi.org/10.1001/archsurg.2012.1649
ER  -