腹部大動脈腸骨動脈瘤に対する血管内治療の有効性解析：単一施設の後ろ向き研究

In the study, we aimed to analyze the early and mid-term outcomes of treating abdominal aorto-iliac 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, re-intervention, 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% (66/67). 6 patients (10.2%) developed buttock claudication in unilateral IIAs occlusion. There were 3 cases (4.5%) of early re-intervention 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%. 4 patients (6.0%) underwent unplanned late re-intervention, 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 one IIA was recommended.