Amr Abdulbaky, Ahmed Elmahrouky
AmrAbdulbaky, Ahmed Elmahrouky, Ahmed Sayed, Ahmed Gamal
Ashrf Abo-Elftooh Khalil, Ahmed F. AboRady, Ahmed Nawwar, Ahmed Ragab Morsi
Khaled E. Soliman M.D, Medhat M. Anwar M.D, Yasser S. Ahmed M.D, Samy E. Ibrahim M.D, Moustafa M. Abd El-Baki M.D, Mohamed H. Sultan M.Sc.
Hisham Mostafa (MD)1 , Usama Lotfi (MD, MRCS)1 , Ahmed Abdulrahman (MSc) 2
Mohamed El-Maadawy, MD, Ahmed Gamal, MD & Usama Lotfi, MD
Mahmoud S. Elbasiouny
Ahmed El-Marakby¹, Ahmed Faragaly¹
Hossam Elmahdy, M.D, Walied Eldaly, M.D, Baker Ghoneim, M.D
Dina Hany1,*, MD, Wafi Fouad2,*, MD and Ramy Mikhael Nageeb1,*, MD
Dina Hany1,*, MD, Wafi Fouad2,*, MD and Ramy Mikhael Nageeb1,*, MD
Khaled E. Soliman1 , Noha M. Ragab2 , Omar Shebl Zahra3
1Emad Abdellatif Daoud1M.D and 2Dahlia M. Dalam, M.D
Mohamed Riad and Basem M. Sieda
Ahmed Mahmoud Hussein1MD; Nader Makram Milad1MD; Mohammed Diaa Sarhan 1 MD; Ahmed Shaddad Abdel Wahed2 M.Sc.
1Gamal El Zaiady, 2Rasha Abdelkader, 2Sameh El Noamani
Ahmed A. Nawar, Rasha Abdelkader, Fady M. Yacoub
Abdrabou N. Mashhour MD
1Amr Saleh Elbahaey, 2Ahmed Aly Radwan
Endovascular Aortic Revascularization As A First Line of Treatment of Complex Aorto-Iliac Occlusive Disease in Patients with Co-Morbidities Precluding Open Surgery
Introduction: Complex infrarenal aortic disease is rare. Short focal lesions are best treated by
endovascular means, while long lesions are better treated surgically. The aim of the study is to evaluate the
feasibility, patency and complications of endovascular management of complex aorto-iliac occlusive
disease (AIOD). Patients and Methods: This is a prospective study of patients with complex AIOD
presenting to Kasr Al-Ainy hospital in the period from June 2013 to June 2015. CT Angiography was
performed in all patients to plan the procedure access and tools. All lesions were pre-dilated with an
undersized balloon, and then were stented either by self-expandable stents, Balloon-expandable stents or
covered stents according to our pre-study selection criteria. Technical success, Clinical success,
Complications and follow up were reported. Results: Thirteen patients were included in this study. Eight
cases had total occlusions (3 of them were Juxtarenal extending into the iliac bifurcation and 5 were at the
distal aorta extending into the commom iliac artery(CIA). The other five cases had tight and long stenoses
of the distal aorta extending into CIAs. We used 35 stents: 22 self expandable stents, 7 balloon-expandable
stents and 6 covered stents. Technical success was achieved initially in all patients. One limb was
amputated due to extensive pre-procedural infrainguinal disease. one patient died in the first postoperative
day and another patient died 3 months later. Clinical success was achieved in the remaining 11 patients.
Conclusion: Endovascular aortic revascularization shows promising early and midterm results. Initial
results justify its use as a first choice. Large scale studies with longer follow up are awaited for to establish
its role in the management of complex aorto-iliac disease in comparison to open surgery.
Keywords: aortic occlusion - endovascular.