Clinical application of endovascular grafts in aortoiliac occlusive disease and vascular trauma

Intravascular stents and stented grafts are becoming important tools for the management of a variety of vascular lesions. This review addresses the technical feasibility and early results of aortoiliac endovascular reconstructions for limb salvage as well as the placement of stented grafts for the treatment of traumatic arterial lesions. Eighteen patients with limb-threatening ischemia secondary to aortoiliac and femoropopliteal occlusive disease who were poor candidates for standard arterial bypass operations and eight patients with traumatic arterial lesions (two arteriovenous fistulas; six pseudoaneurysms) were treated with endovascular stented grafts. These were constructed of 6-mm tubular polytetrafluoroethylene (GORE-TEX) and balloon-expandable stents (Palmaz). Technical success was achieved in 95% of grafts placed to treat long segment occlusive disease of the iliofemoral arteries and in 100% of grafts placed to treat traumatic arterial injuries. There were no deaths and only minor complications in both groups. Although the early results with these grafts are encouraging, long-term follow-up is needed before such devices can be recommended for widespread use.