3:00 PM Abstract No. 151 ■ DISTINGUISHED ABSTRACT Endovascular reconstruction for TASC-II D aorto-iliac occlusive disease achieves equivalent long-term outcomes compared to surgical bypass

Purpose: To compare the clinical outcomes and safety of endovascular reconstruction of occlusive and near-occlusive disease of the aortic bifurcation to surgical bypass. Materials: Thirty-Two consecutive patients with symptomatic TASC-II D Aorto-Iliac Occlusive Disease (AIOD) who underwent surgical bypass or endovascular reconstruction from 2012 to 2017 were retrospectively reviewed. Lesion characteristics, technical approach, survival, limb salvage, patency, and change in clinical symptoms were analyzed. Results: Nineteen patients at prohibitive risk for open surgery underwent endovascular reconstruction, while thirteen underwent surgical bypass. Interventions were performed for debilitating claudication (61%), chronic limb-Threatening ischemia (CLTI, 24%), and acute limb ischemia (ALI, 15%). There were no significant differences in Rutherford classification between groups. Kissing stent technique was used in all patients for reconstruction of the aortic bifurcation. During long-Term follow-up (LTFU) of 2.8 years, endovascular reconstruction compared to surgical bypass demonstrated equivalent survival (89% vs 85%, p = 0.69), limb salvage (100% vs 92%, p = 0.23), and primary/primaryassisted patency (84% vs 85%, p = 0.98). The endovascular group had decreased operative time (157 vs 245 minutes, p