This study aims to evaluate the midterm outcomes of patients with advanced aortoiliac artery narrowing (TASC C-D lesions) who were treated with covered iliac stent-grafts instead of open surgery. These patients were either too high-risk for surgery or refused it. Medical records from the past five years at a single cardiovascular surgery center in Turkey were reviewed retrospectively. The research focuses on the success rate of the procedure, complications, vessel patency, and the need for additional treatments. The results may help guide treatment decisions in similar high-risk patients who are not candidates for open vascular surgery.

This is a single-center retrospective cohort study evaluating intermediate-term outcomes of patients with aortoiliac occlusive disease who underwent endovascular treatment using covered iliac stent-grafts. The study includes patients with complex iliac artery lesions (typically classified as TASC II C or D) treated over the past five years. Open surgery was not feasible or preferred in these cases due to high surgical risk or patient refusal.The study analyzes medical records to assess technical success, symptom improvement, complication rates, vessel patency, and the need for reintervention. Results may inform the role of covered stent-grafts as a viable alternative in managing advanced aortoiliac disease in high-risk patients.

Inclusion Criteria:

1. Patients with TASC C-D iliac artery lesions
2. Procedures done within last 5 years in the same clinic
3. Aged between 18-85 years
4. Not eligible for open surgery or refused it

Exclusion Criteria:

1. TASC A-B lesions
2. Age <18 or >85

Patients diagnosed with peripheral artery disease and TASC C-D iliac lesions treated with covered stents between 2018 and 2023