Clinical outcomes of endovascular stenting versus bypass surgery for aortoiliac occlusive disease: a single-center retrospective cohort study

Abstract

Background This study aimed to compare perioperative and follow-up outcomes between endovascular stenting and bypass surgery in patients with aortoiliac occlusive disease (AIOD). Materials and methods This single-center retrospective cohort study included 78 patients with aortoiliac occlusive disease between January 2015 and January 2021, including 58 who underwent endovascular stenting and 20 who underwent bypass surgery. Perioperative complications, healthcare utilization, overall survival, primary patency, freedom from reintervention, and limb-related outcomes were compared between the groups. Results Among the 78 included patients, the technical success rate was 100% in both groups. Postoperative systemic complications occurred in 3 patients (5.1%) in the ES group and 10 patients (50.0%) in the BS group (P < 0.001). Procedure-related complications occurred in 8 patients (13.8%) in the ES group and 1 patient (5.0%) in the BS group (P = 0.434). The median length of hospital stay was 7 days in the ES group and 17 days in the BS group (P < 0.001). No statistically significant between-group differences were observed in survival (P = 0.111), primary patency (P = 0.993), freedom from reintervention (P = 0.447), and freedom from any amputation (P = 0.750). Conclusion In this selected retrospective cohort, endovascular stenting was associated with shorter hospitalization and fewer systemic complications than bypass surgery. No statistically significant differences in procedure-related complications, survival, primary patency, reintervention, or limb-related outcomes were observed during follow-up. These findings should be interpreted cautiously because of the small sample size, treatment-selection bias, and differences in follow-up duration.