ABSTRACT
The long-term success of aortoiliac intervention is closer to the results of open surgery than with any other endovascular intervention. Isolated, focal stenoses of the infrarenal abdominal aorta often respond to balloon angioplasty alone, and the approach has reasonable long-term success, but stent placement has even better results over the long run. Lesions that are limited to the infrarenal aorta may be accessed through a unilateral femoral approach on either side. Lesions of the aorta that extend near or into the aortic bifurcation should be accessed with a guidewire placed through each iliac artery. Aortic bifurcation stenoses that extend into the proximal common iliac arteries are treated with a kissing technique; access and treatment are performed through both iliac arteries. Iliac artery balloon angioplasty and stenting is the index endovascular procedure. It is a common procedure and has had a profound impact on the management of atherosclerotic occlusive disease.
