Clinical impact of hypogastric artery occlusion in endovascular aneurysm repair

Vascular. 2015 Dec;23(6):575-9. doi: 10.1177/1708538114560462. Epub 2014 Nov 20.

Abstract

Purpose: To report the long-term results for patients treated with endovascular aneurysm repair and additional embolization and coverage of the hypogastric artery compared with patients treated with simple endovascular aneurysm repair.

Methods: A database of our endovascular aneurysm repair patient cohort was reviewed to find patients with iliac artery aneurysms. The baseline characteristics, the procedural data and the results for patients treated with endovascular aneurysm repair and concomitant hypogastric artery embolization were compared with those for patients treated with simple endovascular aneurysm repair. The results were analyzed for significant differences.

Results: Of 106 endovascular aneurysm repair patients treated at our vascular unit from 2001 to 2010, 24 had undergone additional hypogastric artery embolization. The complication rate was significantly increased in this group (12.5% vs. 2.4%; p = 0.041), and the long-term results were significantly poorer. Additional hypogastric artery embolization resulted in late rupture (1.2% vs. 12.5%; p = 0.036), buttock claudication (8.6% vs. 43.8%; p = 0.001) and new onset erectile dysfunction (17.3% vs. 42.9%; p = 0.043).

Conclusion: Endovascular aneurysm repair with extension of the stent graft to the external iliac artery and embolization of the hypogastric artery was associated with more complications and worse long-term results compared with simple endovascular aneurysm repair.

Keywords: Endovascular aneurysm repair; hypogastric artery; iliac artery aneurysm.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aneurysm, Ruptured / etiology
  • Aortic Aneurysm, Abdominal / diagnosis
  • Aortic Aneurysm, Abdominal / therapy*
  • Austria
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Databases, Factual
  • Embolization, Therapeutic* / adverse effects
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / instrumentation
  • Erectile Dysfunction / etiology
  • Female
  • Humans
  • Iliac Aneurysm / diagnosis
  • Iliac Aneurysm / therapy*
  • Intermittent Claudication / etiology
  • Male
  • Pelvis / blood supply*
  • Stents
  • Time Factors
  • Treatment Outcome