• Huei-Lung Liang, Ming-Feng Li, Chia-Chi Hsiao, Chieh-Jen Wu, and Tung-Ho Wu.
• Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung City, Taiwan, ROC. Electronic address: hlliang@vghks.gov.tw.
• J Formos Med Assoc. 2021 Jul 1; 120 (7): 1485-1492.

BackgroundBypass grafting is the standard of care for chronic aorto-iliac occlusive disease (AIOD, aka Leriche Syndrome) but is associated with mortality rates of up to 25% if surgical re-intervention is necessary. Despite a recent shift towards an endovascular-first strategy for TransAtlantic InterSociety Consensus II ("TASC II") C and D lesions, reports from Leriche Syndrome are still limited.Patients And Methods15 high-risk patients (11 male, 4 female), mean age of 60.6 years, with chronic aorto-iliac occlusive disease were retrospectively reviewed. Retrograde approaches via the bilateral femoral arteries for aortic occlusion less than 4 cm in length and/or antegrade fashion from the brachial artery for juxtarenal type lesions were made. For the latter, thrombolysis prior to angioplasty was also performed. Intraluminal or if necessary, subintimal angioplasty was performed with deployment of either bare metal stents or stentgrafts in a kissing-stent fashion.ResultsA total of 28 iliac arteries and 14 occluded abdominal aorta were treated with 100% technical success, of which 25% success were achieved by using subintimal technique. Two minor complications occurred, including vascular rupture and distal emboli in one patient apiece, which were successfully managed via endovascular fashion. There were no complications of renal artery emboli. Primary and secondary patency rates at 1, 3 and 5 years were 92.3% and 100%; 83.9% and 100%; and 83.9% and 100%, respectively.ConclusionEndovascular therapy for chronic aorto-iliac occlusion has a high technical success rate, with good short- and mid-term primary and secondary patency rates and may provide a valid alternative to surgery for high-risk patients.Copyright © 2020 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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