Result of bifurcated devices to protect the internal iliac in aorto-iliac aneurysms

Original title: Endovascular Treatment of Aorto-iliac Aneurysms: Four-year Results of Iliac Branch Endograft. Reference: G. Pratesi et al. Eur J Vasc Endovasc Surg. 2013 Jun;45(6):607-9.

Iliac bifurcated devices have proven to be effective in treating common iliac aneurysms but the findings are based on small series, generally from a sole center experience. This multicenter registry included 85 patients with aorto-iliac aneurysms who received bifurcated devices, (most of them, Zenith Bifurcated Iliac sidebranch, Cook, Bloomington, IN, USA). Technical success was achieved in 98.7% with no perioperative mortality. The only case that could not be implanted was probably due to a very challenging anatomy.

During the first 30 days only a single occlusion of iliac branch was observed and at follow-up CT scan, three patients (3.7%) had distal type I endoleak. These patients were managed conservatively with strict surveillance protocol but thus far showed no sac growth. At follow-up (20.4 ± 15.4), seven unrelated deaths occurred leaving an estimated 24-month survival of 89.5% and 76.7% after 48 months. During follow-up there were no aneurysm-related deaths, need for conversion to conventional surgery or aneurysmatic rupture. No new branch thrombosis was registered.  

Seven patients (8.6%) progressed with buttock claudication, six of them were bilateral iliac aneurysms cases where one hypogastric was protected with a bifurcated branch and the other was embolized. The symptoms were always confined to the side of the embolized hypogastric and did not improve with time. 

Conclusion:

Iliac bifurcated devices were effective in preserving the internal iliac artery implant in the context of an abdominal aortic stent. This represents a valid technique in the case of bilateral iliac aneurysms. 

Commentary:

All patients who developed a distal type I endoleak had an ectatic internal iliac artery. Perhaps the compromise of this artery by the common iliac aneurysm should be considered as a limitation of the technique.

SOLACI.ORG

More articles by this author

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....

Chronic Thromboembolic Pulmonary Hypertension: Treatment Outcomes According to a Worldwide Registry

Chronic thromboembolic pulmonary hypertension (CTEPH) is a highly limiting condition that, despite its moderate incidence, significantly impacts patient prognosis and quality of life. The...

Contemporary Outcomes of Acute Limb Ischemia Endovascular Revascularization

Acute limb ischemia (ALI) is a vascular emergency with high mortality rate. It has been defined as a sudden occlusion of limb perfusion compromising...

TCT 2024 | SIRONA: Randomized Study Comparing Sirolimus-Coated vs Paclitaxel-Coated Balloon Angioplasty in Femoropopliteal Disease

This prospective, randomized, multicenter, investigator-initiated non-inferiority study compared the use of sirolimus-coated balloon (MagicTouch) vs paclitaxel-coated balloon in endovascular treatment.  The primary objective was to...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Long Term Results of the International Chimney Registry

The International Chimney Registry was an observational study aimed at assessing the use of chimney stenting during TAVR either to predict or treat coronary...

CANNULATE TAVR extended study: Impact of Commissural and Coronary Alignment in Coronary Cannulation Following TAVR with Evolut Fx

The new valve Evolut FX has shown better commissural alignment vs. its predecessor Evolut Pro+. Prior studies have already shown commissure alignment facilitates post...

TRISCEND II: Transcatheter Replacement vs. Medical Treatment for Tricuspid Regurgitation

The EVOQUE device is designed with an intra-annular sealing system that provides excellent anatomical compatibility and an adaptable shape. It is currently available in...