Common Iliac Artery Aneurysm Repair with Hypogastric Preservation via Balloon-Expandable Covered Stents Using the Eyelet Technique-Iliac Branched Devices Still Inappropriate in Many Patients

Autor: Michael Levine, John S. Lane, Dennis F. Bandyk, Rachel Jensen, Antonio Covarrubias, Mahmoud B. Malas, Andrew Barleben, Erik L. Owens
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Databases
Factual
Clinical Decision-Making
Ischemia
030204 cardiovascular system & hematology
Balloon
Prosthesis Design
Iliac Artery
Risk Assessment
030218 nuclear medicine & medical imaging
03 medical and health sciences
Blood Vessel Prosthesis Implantation
0302 clinical medicine
Aneurysm
Postoperative Complications
Risk Factors
medicine.artery
Medicine
Humans
Veterans Affairs
Covered stent
Vascular Patency
Aged
Retrospective Studies
Aged
80 and over
business.industry
Endovascular Procedures
General Medicine
Middle Aged
medicine.disease
Common iliac artery
Surgery
Blood Vessel Prosthesis
Balloon expandable stent
medicine.anatomical_structure
Treatment Outcome
Regional Blood Flow
Iliac Aneurysm
Female
Stents
Cardiology and Cardiovascular Medicine
business
Artery
Zdroj: Annals of vascular surgery. 71
ISSN: 1615-5947
Popis: Background Common iliac artery aneurysms (CIAAs) are seen in 20–40% of patients with abdominal aortic aneurysms. Historically treated with sacrifice of the hypogastric artery, which can result in significant morbidity related to pelvic ischemia, new devices have made hypogastric artery preservation more feasible but are only applicable to a small subset of aneurysm anatomy. We sought to assess the safety and efficacy or a novel technique for hypogastric artery preservation applicable to a wider variety of patients with CIAAs. Methods We conducted a retrospective review of a prospectively maintained database of all patients with CIAAs treated with a novel endovascular technique at the UC San Diego Sulpizio Cardiovascular Center or the San Diego Veterans Affairs Hospital between March 2016 and December 2017. The endovascular technique involved stent placement in both the internal and external iliac arteries, with balloon expansion to minimize gutters between the endografts. Primary end points included technical success, limb patency, and presence of endoleaks (ELs). Results A total of 14 limbs (12 patients) were treated for CIAAs with 100% technical success and limb patency at an average of 6.8 months of follow-up. No patients experienced type I or type III ELs or evidence of pelvic ischemia. Two patients required reintervention, and one patient died of causes unrelated to the procedure. Conclusions This technique was performed with excellent short- and mid-term safety in patients with varying aneurysm anatomy. The high rates of technical success and low rate pelvic ischemia represent improvement over conventional techniques that sacrifice the hypogastric artery and warrant further testing in a larger patient series with longer term follow-up.
Databáze: OpenAIRE
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