Occlusive disease of the aorta and iliac arteries may lead to incapacitating claudication or, critical limb 
ischemia. Until recently, symptomatic stenoses or occlusions at the aortoiliac bifurcation were generally 
treated surgically with aorto-bi-femoral grafts. However, although these interventions are highly effective 
(5-year patency rate of more than 91%), they are also associated with significant morbidity (8.3%) and 
mortality (3.3%). As an alternative to surgical treatment, endovascular intervention deploying percutaneous 
transluminal angioplasty with placement of aortoiliac kissing stents has been introduced to treat aorto-iliac 
occlusive disease. The aim of this study is to show the results of 5-year follow up of cases treated with the 
Kissing stent technique, done between June 2006 and May 2008, as regards primary and secondary patency 
rates, clinical improvement, ABI, complications (and how managed) and mortality. The study included 
sixty-two patients; twelve of them with TASC A(19.3%), thirty three with TASC B (53.3%), and seventeen 
selected cases of TASC C (27.4%)(those not extending to or involving the common femoral artery). Five-year 
primary and secondary patency rates were 71% and 81%, respectively. Hemodynamically significant 
restenosis developed in nine patients (14.5%). The management of restenosis was endovascular in eight 
patients and was successful in all (balloon dilation-PTA alone- in four, dilataion and restenting in the other 
four) and operative in one patient who developed aortic occlusion and underwent aortobifemoral grafting. 
Seven cases (11.3%) were totally occluded; 3 redilated and 4 operated upon. Most common intra-procedural 
complications were, access site hematomas distal embolization, and arterial dissections. The majority of 
complications could be treated using percutaneous or noninvasive techniques, only one case of thrombosis 
required urgent Aorto-bi-femoral bypass. One patient had major amputation due to distal disease and with 
patent stents. Conclusion: Endovascular treatment of extensive AIOD can be performed successfully in
TASC A, B and selected patients of TASC C. Although primary patency rates are lower than those reported 
for surgical revascularization, reinterventions can often be performed percutaneously, with secondary 
patency fairly comparable to surgical repair. TASC D and TASC C with involvement of CFA should be 
primarily treated surgically.