Iliac branch graft in the treatment of complex aortoiliac aneurysms: early results from a North American institution

J Vasc Interv Radiol. 2011 Apr;22(4):542-9. doi: 10.1016/j.jvir.2011.01.429.

Abstract

Purpose: To describe early experience with the use of iliac branch grafts (IBGs) in aortoiliac aneurysm repair.

Materials and methods: From July 2007 to August 2009 (25 months), 14 patients (13 men, one woman) with a mean age of 70.1 years (range, 59.3-80.0 y) were treated with IBGs. Indications were abdominal aneurysm with common iliac artery (CIA) involvement (n = 11), juxtarenal aortic aneurysm with CIA involvement (n = 1), and bilateral CIA and internal iliac artery (IIA) aneurysms (n = 1). Postoperative endoleaks and patency rate were determined with computed tomography within 1 month of implantation and 1 year thereafter, with concurrent clinical evaluation for pelvic ischemia. Mean follow-up period was 18.7 months (range, 6-35 mo).

Results: Technical success rate, as defined by successful implantation of IBG with no intraprocedural type I or type III endoleak, was 86% (12 of 14). A total of 14 IBGs were successfully deployed in 12 patients. Two cases of technical failure were related to excessive iliac tortuosity. The mean hospitalization duration was 6.5 days (range, 3-14 d), with zero mortality at 30 days. There were two cases of type II endoleak treated conservatively and a single case of IBG-related type III endoleak that required repeat intervention. The rest of the stent-implanted aortic and iliac aneurysms remained stable in size, with no aneurysm rupture or death recorded. All stent-implanted iliac branches remained patent on follow-up. None of the patients who received IBGs had new symptoms of pelvic ischemia.

Conclusions: Iliac branch graft placement is a feasible technique with excellent short-term results in the treatment of aortoiliac aneurysms.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / complications
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Endoleak / etiology
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Feasibility Studies
  • Female
  • Humans
  • Iliac Aneurysm / complications
  • Iliac Aneurysm / diagnostic imaging
  • Iliac Aneurysm / surgery*
  • Ischemia / etiology
  • Length of Stay
  • Male
  • Middle Aged
  • Ontario
  • Pelvis / blood supply
  • Prosthesis Design
  • Reoperation
  • Retrospective Studies
  • Stents*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome