Endovascular and Hybrid Management of Patients Affected by Abdominal Aortic Aneurysm and Occlusion of the Iliac Arteries

Ann Vasc Surg. 2019 Apr:56:147-152. doi: 10.1016/j.avsg.2018.08.093. Epub 2018 Nov 23.

Abstract

The presence of a concomitant aortoiliac occlusive disease and abdominal aortic aneurysm (AAA) is rare and limits the implant of a bifurcated endograft.

Background: The objective of the study was to evaluate early and midterm results of an endovascular or a hybrid approach in patients undergoing iliac revascularization and AAA exclusion.

Methods: We reviewed our clinical series of patients from January 2016 to February 2018. Inclusion criterion was an iliac occlusion with concomitant aortic aneurysm.

Results: We treated 8 male patients: 8 common iliac arteries (CIAs) and 5 external iliac arteries (EIAs). We implanted 8 bifurcated devices and 13 covered stents, 8 in CIA and 5 in EIA. In 5 cases, when the EIA was involved, we also performed a common femoral artery endarterectomy with a patch. During a mean follow-up of 10 months, the primary patency of the recanalized iliac arteries was 100%, no endoleaks, sac growth, or rupture were also recorded.

Conclusions: Endovascular or hybrid treatment of the iliac occlusion combined with infrarenal aortic aneurysm is feasible with favorable early and midterm results.

MeSH terms

  • Aged
  • Ankle Brachial Index
  • Aortic Aneurysm / complications
  • Aortic Aneurysm / diagnostic imaging
  • Aortic Aneurysm / surgery*
  • Aortography / methods
  • Arterial Occlusive Diseases / complications
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / surgery*
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Computed Tomography Angiography
  • Constriction, Pathologic
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation
  • Feasibility Studies
  • Humans
  • Iliac Artery / diagnostic imaging
  • Iliac Artery / surgery*
  • Male
  • Middle Aged
  • Prosthesis Design
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome