Endovascular vs. open treatment of severe aortoiliac occlusive disease – outcomes of a kissing, self-expanding covered stent for reconstruction of the aortic bifurcation

• The kissing stents technique represents the endovascular approach of choice to treat aortoiliac obstructive lesions involving the aortic bifurcation. • Self-expanding covered stents are flexible, conformable and available in long lengths, able to adapt to the often calcific, irregular and long atherosclerotic lesions in this area, and to prevent complications like arterial rupture and distal thromboembolism. • In our experience, the five-year primary patency rate of kissing self-expanding covered stents for the treatment of TASC C-D lesions is 90%, similar to aortobifemoral bypass, although with shorter length of hospitalisation and lower cumulative surgical complication rate. • Clinical presentation, classified as Rutherford category, was the only independent predictor of patency.