Isolated Common Iliac Artery Aneurysms Treated Solely With Iliac Branch Stent-Grafts: Midterm Results of a Multicenter Registry. (April 2018)

• Record Type: Journal Article
• Authors: Giaquinta, Alessia; Ardita, Vincenzo; Ferrer, Ciro; Beggs, Clive B.; Veroux, Massimiliano; Barbante, Matteo; Orrico, Matteo; Cao, Piergiorgio; Veroux, Piefrancesco
• Other Names: Mangialardi Nicola non-byline-author.; Ronchey Sonia non-byline-author.; Lenti Massimo non-byline-author.; Verzini Fabio non-byline-author.; Parlani Gianbattista non-byline-author.; Ippoliti Arnaldo non-byline-author.; Pratesi Giovanni non-byline-author.; Coscarella Carlo non-byline-author.; Setacci Carlo non-byline-author.; de Donato Gianmarco non-byline-author.; Galzerano Giuseppe non-byline-author.; Pratesi Carlo non-byline-author.; Fargion Aaron non-byline-author.; Veroux Chiara non-byline-author.; Mociskyte Dovile non-byline-author.; De Marco Ester non-byline-author.; Virgilio Carla non-byline-author.; Virgilio Vittorio non-byline-author.
• Is Part Of: Journal of endovascular therapy. Volume 25:Number 2(2018:Apr.)
• Page Start: 169
• Page End: 177
• Publication Date: 2018-04
• Subjects: aneurysm -- common iliac artery -- endovascular repair -- iliac artery aneurysm -- iliac branch device -- iliac branched stent-graft -- internal iliac artery; Blood-vessels -- Endoscopic surgery -- Periodicals; Angioscopy -- Periodicals; Intravenous catheterization -- Periodicals; Peripheral vascular diseases -- Treatment -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioscopy -- Periodicals; Catheterization, Peripheral -- Periodicals; Peripheral Vascular Diseases -- therapy -- Periodicals; Angioscopie; Maladies vasculaires périphériques; 617.413
• DOI: 10.1177/1526602818754862
• Languages: English
• ISSNs: 1526-6028

Abstract

Purpose: To assess early and midterm outcomes of iliac branch device (IBD) implantation without an aortic stent-graft for the treatment of isolated common iliac artery aneurysm (CIAA).Methods: From December 2006 to June 2016, 49 isolated CIAAs in 46 patients were treated solely with an IBD at 7 vascular centers. Five patients were lost to follow-up, leaving 41 male patients (mean age 72.5±7.8 years) for analysis. Mean CIAA diameter was 39.1±10.5 mm (range 25–65). Thirty-two patients (2 with bilateral CIAAs) were treated with a Cook Zenith iliac branch device; 9 patients (1 bilateral) received a Gore Excluder iliac branch endoprosthesis. Primary endpoints were technical success, survival, aneurysm exclusion, device patency, and freedom from reintervention at 1 and 5 years. Freedom from major adverse events and aneurysm shrinkage at 1 year were also assessed.Results: Thirty-day mortality and the IBD occlusion rate were 2.4% and 2.3%, respectively. At a mean follow-up of 40.2±33.9 months, no patient presented buttock claudication, erectile dysfunction, or bowel or spinal cord ischemia. Three patients died within 6 months after the procedure. Estimates of cumulative survival, device patency, and freedom from reintervention were 90.2%, 95.2%, and 95.7%, respectively, at 1 and 5 years. At 1 year, CIAA shrinkage ≥5 mm was recorded in 21 of 38 survivors. No evidence of endoleak, device migration, or disconnection was found on imaging follow-up.Conclusion: The use of IBDs without an aortic stent-graft for isolated CIAAs resulted in excellent patency, with low morbidity and mortality. This, in conjunction with no endoleak or migration and a low reintervention rate, supports the use of isolated IBDs as a stable and durable means of endovascular reconstruction in cases with suitable anatomy. Longer follow-up and a larger cohort are needed to validate these results.