Efficacy Analysis of Endovascular Repair for Abdominal Aortoiliac Aneurysm: A Retrospective Single-Center Study

In the study, we aimed to analyze the early and mid-term outcomes of treating abdominal aortoiliac aneurysms (AIAs) with endovascular repair in our center.

This was a retrospective review of patients undergoing endovascular repair for AIAs from January 2020 to January 2024. Primary outcomes were mortality and technical success. Secondary outcomes included major complications, stent patency, reintervention, incidence of endoleak, and freedom from pelvic ischemia.

A total of 67 abdominal aortic aneurysms and 127 iliac artery aneurysms were treated in 67 patients (mean age, 75.3 years; 79.1% men). Unilateral internal iliac artery (IIA) embolization and coverage + contralateral IIA preservation were the main methods in 59 cases (88.1%), leaving 8 cases (11.9%) of bilateral IIAs preservation. Technical success was 98.5% (66 of 67). Six patients (10.2%) developed buttock claudication in unilateral IIAs occlusion. There were 3 cases (4.5%) of early reintervention and 8 cases (11.9%) of major complications. The median follow-up duration was 19.0 months (range, 1-53 months). Survival rates at 30 days, 12 months, and 36 months were 98.5% ± 1.5%, 98.5 ± 1.5%, and 88.4 ± 5.0%, respectively. One aneurysm-related death (1.5%) occurred at 17 months postoperatively. Estimates up to 36 months, the cumulative primary patency rate was 95.5% ± 2.6% and the cumulative primary-assisted and secondary patency rate was 100%. Four patients (6.0%) underwent unplanned late reintervention, 13 cases (18.6%) had endoleaks during the follow-up.

The early and mid-term results of endovascular repair for treating AIAs were favorable, and preserving at least 1 IIA was recommended.