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We investigated the safety and efficacy of primary aorto-uni-iliac (AUI) endovascular aortic repair (EVAR) without fem-fem crossover in patients with abdominal aortic aneurysm (AAA) and concomitant aortoiliac occlusive disease. 537 EVARs were implemented between 2002 and 2015 in University Hospital Galway, a tertiary referral center for aortic surgery and EVAR. We executed a parallel observational comparative study between 34 patients with AUI with femorofemoral crossover (group A) and six patients treated with AUI but without the crossover (group B). Group B patients presented with infrarenal AAAs with associated total occlusion of one iliac axis and high comorbidities. Technical success was 97% ( n  = 33) in group A and 85% ( n  = 5) in group B ( P  = 0.31). Primary and assisted clinical success at 24 months were 88% ( n  = 30) and 12% ( n  = 4), respectively, in group A, and 85% ( n  = 5) and 15% ( n  = 1), respectively, in group B ( P  = 0.125). Reintervention rate was 10% ( n  = 3) in group A and 0% in group B ( P  = 0.084). No incidence of postoperative critical lower limb ischemia or amputations occurred in the follow-up period. AUI without crossover bypass is a viable option in selected cases.

international journal of vascular medicine

Aorto-Uni-Iliac Stent Grafts with and without Crossover Femorofemoral Bypass for Treatment of Abdominal Aortic Aneurysms: A Parallel Observational Comparative Study