Background: Endovascular repair for abdominal aortic aneurysm (AAA) was developed to provide a less invasive method than the standard open procedure and has been reported to reduce perioperative mortality, hospital stays, and intensive care unit (ICU) stays. However, an unfavorable anatomy precludes the use of a standard bifurcated stent graft, especially in cases with narrow aortic bifurcation. The aorto-uni-iliac (AUI) configuration with a femorofemoral bypass graft appears to be a good alternative in these patients.
Objective: To present the results of the AUI stent graft with femorofemoral bypass graft for AAA during perioperative periods.
Material and Method: The data from 362 patients with AAA from January 2010 to December 2013 at a single institution were retrospectively analyzed. Patients undergoing open repair or endovascular repair with bifurcated graft were excluded. Sixtytwo patients underwent AUI with femorofemoral bypass graft for treatment of AAA over the four-year period. Primary
endpoint was perioperative mortality. Secondary endpoints included procedural details, intra-operative adverse events,
postoperative complication, hospital stays, and perioperative re-intervention.
Results: Mean age was 75+8 years (range, 49 to 92 years). Thirty-two patients (61.3%) underwent AUI with femorofemoral
bypass graft for non-ruptured AAA and twenty-four patients (38.7%) were performed in ruptured AAA. The perioperative
mortality rate was 5.1%, all of which were ruptured AAA. Mean procedural blood loss was 514 mL (range 50 to 7,000 mL),
and 51.61% required intraoperative blood transfusion. Mean length of postoperative stays was 16.3 days (range, 2 to 59
days). There were eleven (18.6%), seventeen (28.8%) and twenty-four (37.3%) developed local, organ and infective
complications, respectively. In addition, seven patients (11.9%) needed perioperative re-intervention.
Conclusion: AUI stent graft and femorofemoral bypass graft for AAA is feasible in both elective and emergency situations with a low perioperative mortality rate. This procedure is associated with an acceptable rate of perioperative complications and early re-intervention.

Keywords: Abdominal aortic aneurysm, Aorto-uniiliac stent graft, Endovascular aneurysm repair