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Large iliac arteries: a high-risk group for endovascular aortic aneurysm repair

Ciaran O McDonnell1, James B Semmens, Yvonne B Allen

  • 1Department of Vascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. ciaranomcdonnell@gmail.com

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|October 11, 2007
PubMed

Insights

Large iliac arteries (16-22 mm) pose a risk for type Ib endoleaks after endovascular aneurysm repair. Early intervention is recommended for persistent endoleaks to ensure long-term success.

Area of Science:

  • Vascular Surgery
  • Endovascular Repair
  • Aortic Aneurysm Disease

Background:

  • Endovascular Abdominal Aortic Aneurysm Repair (EVAR) is a common treatment.
  • Large iliac arteries present unique challenges for stent-graft sealing.
  • Type Ib endoleaks are a specific complication related to the iliac sealing zone.

Purpose of the Study:

  • To determine if large iliac arteries are a risk factor for type Ib endoleaks.
  • To assess the need for iliac artery-related secondary interventions after EVAR.
  • To evaluate outcomes in patients with large iliac arteries undergoing EVAR.

Main Methods:

  • Retrospective review of 100 patients with large iliac arteries (16-22 mm) treated with Zenith stent-grafts.
  • Analysis of medical records, radiographs, and CT scans.
  • Endpoints included mortality, endoleaks, secondary interventions, and stent-graft migration.

Main Results:

  • Mean follow-up was 30.1 months.
  • 7% of patients developed type Ib endoleaks.
  • 10% required iliac artery-related secondary interventions; 16% overall secondary interventions.

Conclusions:

  • Iliac arteries 16-22 mm can be treated with a cuff to the iliac limb with 90% efficacy.
  • Close surveillance for type Ib endoleaks is necessary.
  • Early secondary intervention for persistent sac enlargement is recommended.
Abstract

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