Endovascular treatment of iliac artery aneurysms with a tubular stent-graft: Mid-term results

• Published in: Journal of vascular surgery Vol. 43; no. 3; pp. 440 - 445
• Main Authors: Tielliu, Ignace F.J., Verhoeven, Eric L.G., Zeebregts, Clark J., Prins, Ted R., Oranen, Björn I., van den Dungen, Jan J.A.M.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.03.2006; Elsevier
• Subjects: Aged; Aneurysm, False - surgery; Biological and medical sciences; Blood and lymphatic vessels; Blood Vessel Prosthesis; Cardiology. Vascular system; Diseases of the aorta; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Elective Surgical Procedures; Emergencies; Follow-Up Studies; Humans; Iliac Aneurysm - surgery; Length of Stay; Medical sciences; Middle Aged; Minimally Invasive Surgical Procedures - methods; Postoperative Complications; Prospective Studies; Stents; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Arterial disease; Vascular disease; Treatment; Surgery; Cardiovascular disease; Endovascular route; Stent; Iliac artery; Artery aneurysm
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2005.10.078

To report the mid term results of a prospective cohort of iliac artery aneurysms (IAAs) treated with endovascular tubular stent-grafts. All IAAs referred to the University Medical Center Groningen between June 1998 and June 2005 were evaluated for endovascular repair. Criteria for repair were a diameter of ≥30 mm for anastomotic aneurysms and ≥35 mm for true aneurysms. Preferentially, tubular grafts were used. Follow-up included both radiographs of the abdomen and duplex examination. In 35 patients, 40 IAAs were treated endovascularly with a tubular stent-graft. Elective repair was performed in 30 patients (86%) and emergent repair in five patients (14%). Aneurysms were false in 26 cases (65%) and true in 14 cases (35%). Local anesthesia was used in 74% of the cases. The stent-grafts that were used included the Excluder contralateral limb (n = 28, 70%), Passager (n = 9, 22.5%), Hemobahn (n = 2, 5%), and Wallgraft (n = 1, 2.5%). The mean operation time was 83 ± 28 minutes (range, 50 to 150 minutes). Mean hospital stay was 3.3 ± 2.3 days (range, 1 to 12 days). There was no 30-day mortality. Patients were followed up for a mean of 31.2 ± 20.7 months (range, 3 to 83 months). Complications occurred in two patients during follow-up, including migration with a proximal type I endoleak in one, and occlusion of the stent-graft in the other. The internal iliac artery was intentionally sacrificed in 28 patients (70%), and this led to gluteal claudication in three patients. Endovascular repair of iliac artery aneurysms with flexible stent-grafts is a minimally invasive technique and is associated with low mortality and morbidity. Follow-up results up to 5 years suggest that the technique is durable. It should be regarded as a first choice treatment option for suitable aneurysms.