227 - Outcomes of Endovascular Recanalization for Complex Aortoiliac TASC-II C & D Occlusions: A Single-Center Experience

Tuesday, April 14, 2026

3:00 PM - 3:09 PM ET

Presenting Author(s)

Si Yeon Kim, MS (he/him/his)

Medical Student
Rosalind Franklin University of Medicine and Science, United States

Author/Co-author(s)

Subhash Gutti, MD (he/him/his)

PGY-2
RUSH VIR, United States
Anna Hu (she/her/hers)

Medical Student
George Washington University School of Medicine and Health Sciences, United States
Kumar Madassery, MD

Associate Professor, Vascular and Interventional Radiology
Rush University Medical Center, Rush Oak Park, United States
UT

Ulku Turba
Bulent Arslan, MD, FSIR

Professor and Interim Chair
Rush University Medical Center, United States
CW

Cayce Workman, MD

Prof.
Rush University Medical Center, United States

Purpose:

Evaluate patency and clinical outcomes of endovascular recanalizations for complex aortoiliac TASC-II C & D occlusions performed at our institution

Materials and Methods:

Retrospective chart review of endovascular recanalizations for aortoiliac TASC-II C & D occlusions from our single center from 2012-present

Patency was confirmed utilizing a combination of ultrasound duplex, CT, and angiographic findings

Longitudinal outcomes were quantified with Kaplan-Meier analysis

Results: A total of 22 patients were included in our analysis. The median age was 69, with 50% males. Significant past medical history included: HTN 77%, HLD 55%, DM 40%, CKD/ESRD 9%, CAD 36%, and smoking history 59%. Of the sample, 54% of patients presented with severe claudication (RC-3), 9% with rest pain (RC-4), 18% with minor tissue loss, and 18% with major tissue loss (RC-6). The technical success rate was 100%. No major complications occurred. The median follow-up time was 19 months.

Patency Rates

The primary patency rate at 6 months was 95% (95% CI: 68-99%). At 12, 24, 36, 48, and 60 months, the primary patency rate was 87% (95% CI: 58-97%).

The primary-assisted patency rate at 6, 12, 24, 36, 48, and 60 months was 95% (95% CI: 68-99%).

The secondary patency rate at 6, 12, 24, 36, 48, and 60 months was 100%.

Symptom-Free Survival

The symptom-free survival (SFS) rate at 6, 12, 24, 36, 48, and 60 months was 94% (95% CI: 65-99%).

Conclusion: Endovascular recanalization of TASC-II C & D occlusions results in excellent long-term patency and clinical outcomes in our single-center experience. Notably, we demonstrate a 5-year primary patency of 87% for endovascular recanalization. By comparison, aortobifemoral bypass (currently the gold standard for TASC-II C & D lesions, per the 2007 TASC-II guidelines), has a comparable 5-year primary patency of 88% in recent literature {1}. Furthermore, endovascular recanalization for TASC-II C & D has been well established to have superiority in morbidity, mortality, and length of stay (LOS) compared to surgery {2}. A limitation of this study is modest sample size, which we aim to expand prior to presentation.

In conclusion, our data supports an endovascular-first approach even for aortoiliac TASC-II C & D occlusions. Although surgical bypass has historically been considered first-line for these complex and/or long-segment occlusions, we argue that surgery should now be reserved for select cases refractory to endovascular management.