The role of branched endografts in preserving internal iliac arteries

• Published in: Journal of cardiovascular surgery Vol. 50; no. 2; pp. 213 - 218
• Main Authors: Tielliu, I F J, Bos, W T G J, Zeebregts, C J, Prins, T R, Van Den Dungen, J J A M, Verhoeven, E L G
• Format: Journal Article
• Language: English
• Published: Italy Edizioni Minerva Medica 01.04.2009
• Subjects: Aged; Algorithms; Aortic Aneurysm - diagnostic imaging; Aortic Aneurysm - surgery; Aortography - methods; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - instrumentation; Clinical Protocols; Feasibility Studies; Female; Humans; Iliac Aneurysm - diagnostic imaging; Iliac Aneurysm - surgery; Male; Middle Aged; Patient Selection; Prosthesis Design; Time Factors; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 0021-9509; 1827-191X

The aim of this study was to report our treatment algorithm and early results with the use of an iliac branched device (IBD) to preserve the internal iliac artery (IIA) in the treatment of aortoiliac and solitary common iliac artery (CIA) aneurysms. From September 2004 on, all patients with aorto-iliac aneurysms with a suitable proximal neck or CIA aneurysms were evaluated. Selection for treatment with an IBD was done based on activity level of the patient and anatomical criteria of the aneurysm. Absolute exclusion criteria included aneurysmal IIA, severe atherosclerosis of the IIA, and small residual CIA lumen. Patients who were at risk of losing one out of two patent IIA were only considered for IBD if they were physically active. Follow-up was performed with computed tomography scanning at six weeks and one year, and thereafter yearly. Fifty-nine patients (39 aorto-iliac, 20 CIA) were evaluated for treatment with an IBD. Seven patients were not considered for IBD for low activity level. Twenty-five patients were not suitable because of adverse anatomy. In total, 27 patients (20 aorto-iliac, 7 CIA) were treated with 30 IBDs. Technical success was achieved in 96.3% of patients. There was no 30-day mortality. Mean follow-up period was 16+/-14 months. In three patients the IIA side branch occluded, resulting in buttock claudication in only one patient. No external iliac artery occlusion or device component disconnection was observed. An IBD provides a totally endovascular option to preserve the IIA in selected aortoiliac and isolated CIA aneurysms. Anatomical application rate for the use of an IBD was 52.5% in our series. Further studies are needed to determine the indications for use of this device.