  Objective:The objective of the current study was to demonstrate the three
year outcome of the CERAB technique for the treatment of extensive aortoiliac
occlusive disease (AIOD). Methods:Between February 2009 and July 2016, all
patients treated with the CERAB technique for AIOD were identified in the local
databases of two centers and analyzed. Demographics and lesion characteristics
were scored. Follow-up (FU) consisted of clinical assessment, duplex ultrasound
and ankle brachial indices (ABI). Patency rates and clinically driven target
lesion revascularization (CD-TLR) were calculated by Kaplan-Meier analysis.
Results: 130 patients (69 male and 61 female) were treated of which 68%
patients were diagnosed with intermittent claudication and 32% suffered from
critical limb ischemia. The vast majority (89%) were TASC-II D lesions and the
remaining were TASC-II B and C (both 5%). Median follow-up was 24 months (range
0-67 months). The technical success rate was 97% and 67% of cases were
performed completely percutaneously. The ABI improved significantly from 0.65
plusminus 0.22 preoperatively to 0.88 plusminus 0.15 after the procedure. The
30-day minor and major complication rate was 33% and 7%. The median hospital
stay was 2 days (range 1-76 days). At 1 and 3-years FU 94% and 96% of the
patients clinically improved at least 1 Rutherford category (2% and 0%
unchanged, 4% and 4% worsened). Limb salvage rate at 1-year was 98% and 97% at
three year follow-up. Primary, primary-assisted and secondary patency was
86%/91%/97% at 1-year, 84%/89%/97% at 2-year and 82%/87%/97% at 3-year FU.
Freedom from CD-TLR was 87% at 1-year and 86% at both 2 and 3-year FU.
Conclusions:The CERAB technique is a safe and feasible technique for the
treatment of extensive aortoiliac occlusive disease with good three year
results regarding patency and clinical improvement.
