AUTHOR=Ren Hong Cheng , Li Tian Run , Zhuang Jin Man , Li Xuan , Luan Jing Yuan , Wang Chang Ming , Ding Ming Chao 

TITLE=Comparison of complete multi-level vs. iliac-only revascularization for concomitant iliac and superficial femoral artery occlusive disease

JOURNAL=Frontiers in Surgery

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2023.1188990

DOI=10.3389/fsurg.2023.1188990

ISSN=2296-875X

ABSTRACT=Objective: The aim of this study is to comparative of the efficacy and safety of complete multi-level versus iliac-only revascularization for the treatment of concomitant iliac and superficial femoral artery (SFA) occlusive disease. 
Methods: 139 consecutive adult patients with severe stenosis and occlusive iliac and SFA disease with a Rutherford category of 2-5 were underwent whether multi-level (n=71) versus iliac-only (n=68) revascularization at the Department of Intervention Vascular Surgery, Peking University Third Hospital and Aerospace Center Hospital, between March 2015 and June 2017. The improvement of Rutherford class, perioperative major adverse events, the length of stay, survival and limb slavage rate were assessed. The neutrophil-lymphocyte ratio and platelet-lymphocyte ratio were compared between the two groups. 
Results: At 48 months, improvement in the Rutherford category was observed in the two groups with no significant difference(P=0.809). Moreover, the two groups were similar concerning the primary patency(84.0% vs 79.1%, P=0.717) and limb salvage rate(93.1% vs 91.3%, P=0.781). A higher proportion of the perioperative major adverse events(33.8% vs 27.9%, P=0.455), the all-cause mortality(11.3% vs 8.8%, P=0.632) and the average length of hospital stay [7.0（6.0,11.0）vs 7.0（5.0,8.0），P=0.037] were seen in the multi-level group compared to the iliac-only group. 
Conclusions: For concomitant iliac and superficial femoral artery occlusive disease, iliac-only revascularization has favorable efficiacy and safety outcomes compared to complete multi-level in selected patients with patent profunda femoris artery and at least one healthy outflow tract of the infrapopliteal artery.