Endografting of the abdominal aorta and iliac arteries for occlusive disease.

Angioplasty and stenting of short segment obstructions is highly effective in the treatment of aorto-iliac occlusive disease. However, long-segment, diffuse and calcific aorto-iliac atherosclerosis is most effectively treated with surgical bypass. While aorto-femoral bypass procedures are durable and effective, too often patients are elderly, high risk and poor candidates for open surgery. Endografting of the abdominal aorta and iliac arteries is aimed at improving the short and long-term results of endovascular treatment of extensive, end-stage aorto-iliac disease. Aorto-iliac endografts are widely used in the treatment of aneurysmal disease. Early experiences with endografts in the treatment of occlusive disease are promising. However, evidence that long-term patency of endografts will be substantially better than angioplasty and stenting is not yet available. Prospective clinical trials are needed to determine the role of endografts in the treatment strategy of aorto-iliac occlusive disease.