Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun 25;11(2):217-222.
doi: 10.3400/avd.oa.18-00007.

Long-Term Results of Crossover Bypass for Iliac Atherosclerotic Lesions in the Era of Endovascular Treatment: The Re-ACTION Study (Re trospective A ssessment of C rossover Bypass as a T reatment for I liac Lesi ON s)

Noriyuki Miyama  1 , Hiroyoshi Komai  1   2   3 , Takashi Nakamura  4 , Masahiro Iwahashi  5   6 , Nobuhiko Mukobara  7 , Masato Yoshida  7 , Hironobu Fujimura  8 , Takaki Sugimoto  9 , Hidenori Asada  10 , Nobuhiro Tanimura  11   12 , Takashi Azami  13 , Masatoshi Kawata  14 , Yoshihiko Tsuji  15 , Noboru Wakita  16 , Hitoshi Ogino  2 , Shunya Shindo  3 , Atsutoshi Hatada  6 , Takanori Oka  12
Affiliations

Long-Term Results of Crossover Bypass for Iliac Atherosclerotic Lesions in the Era of Endovascular Treatment: The Re-ACTION Study (Re trospective A ssessment of C rossover Bypass as a T reatment for I liac Lesi ON s)

Noriyuki Miyama et al. Ann Vasc Dis. .

Abstract

Objective: The aim of this study was to elucidate the long-term results of crossover bypass (CB) for iliac atherosclerotic lesions in the era of endovascular treatment (EVT). Methods: A retrospective multicenter cohort study was performed. CB was performed in 242 patients between 2003 and 2014 by vascular surgeons at multiple medical centers in Japan. Results: Perioperative mortality was 1.7%. Primary patency rates were 86% at 5 years and 82% at 8 years. Univariate analysis showed that critical limb ischemia (Rutherford class 4-6), vein graft, and superficial femoral artery occlusion were significantly associated with low primary patency. In multivariate analysis, only critical limb ischemia influenced primary patency. The secondary patency rate was 87% at both 5 and 8 years. The limb salvage rate was 98% at both 5 and 8 years. The overall survival rates were 71% at 5 years and 49% at 8 years. Conclusion: The long-term results of CB were good in our study, compared with previous reports. Our results suggest that CB remains an option for the arterial reconstruction in unilateral iliac occlusive disease after EVT failed.

Keywords: crossover bypass; long-term results; peripheral arterial disease; unilateral iliac occlusive disease.

PubMed Disclaimer

Figures

None
Fig. 1 Patency rate of crossover bypass analyzed according to the Kaplan–Meier method. (A) Primary patency. (B) Secondary patency.
None
Fig. 2 Limb salvage and survival rate of crossover bypass analyzed according to the Kaplan–Meier method. (A) Limb salvage. (B) Survival.
See this image and copyright information in PMC

References

    1. Norgren L, Hiatt WR, Dormandy JA, et al. Inter-society consensus for the management of peripheral arterial disease. Eur J Vasc Endovasc Surg 2007; 33 Suppl 1: S1-75. - PubMed
    1. Ichihashi S, Higashiura W, Itoh H, et al. Long-term outcomes for systematic primary stent placement in complex iliac artery occlusive disease classified according to Trans-Atlantic Inter-Society Consensus (TASC)-II. J Vasc Surg 2011; 53: 992-9. - PubMed
    1. Ye W, Liu CW, Ricco JB, et al. Early and late outcomes of percutaneous treatment of TransAtlantic Inter-Society Consensus class C and D aortoiliac lesions. J Vasc Surg 2011; 53: 1728-37. - PubMed
    1. Rutherford RB, Baker JD, Ernst C, et al. Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg 1997; 26: 517-38. - PubMed
    1. Mingoli A, Sapienza P, Feldhaus RJ, et al. Femorofemoral bypass grafts: factors influencing long-term patency rate and outcome. Surgery 2001; 129: 451-8. - PubMed

LinkOut - more resources