Clinical outcome of internal iliac artery occlusions during endovascular treatment of aortoiliac aneurysmal diseases.
OBJECTIVE
To determine the clinical outcome of hypogastric artery occlusion in patients who underwent endovascular treatment of aortoiliac aneurysmal disease.


METHODS
From January 1994 to March 1998, 94 patients underwent endovascular treatment of aneurysmal diseases involving the infra-abdominal aorta or iliac arteries. Preoperative and intraoperative radiologic data were reviewed. Discharge summaries, clinic visits, and phone calls formed the basis for clinical follow-up, with a mean follow-up period of 7.3 months (range, 1-24 months).


RESULTS
Because of the anatomy of the aneurysms, 28 patients required occlusion of one or more hypogastric arteries. One of the 28 patients died of unrelated causes before follow-up. Seven (26%) of the remaining 27 patients developed symptoms attributable to the hypogastric artery occlusions. Five patients developed new buttock or thigh claudication; of these five patients, three with initially mild symptoms noted complete or near complete resolution of symptoms upon follow-up. One patient with originally significant claudication at 2-year follow-up noted near resolution of symptoms. The other patient with severe pain did not improve significantly on final 1-year follow-up before his death (of unrelated causes). Other clinical complications were worsening sexual function in one patient and a nonhealing sacral decubitus ulcer that developed in a debilitated patient in the postoperative setting, which required surgery. No bowel ischemia was observed.


CONCLUSIONS
When treating aortoiliac aneurysmal disease through an endovascular approach, the occlusion of internal iliac artery is often necessary but carries with it a small but finite chance of morbidity.
Lee
C W
CW
Division of Vascular and Interventional Radiology, Massachusetts General Hospital, Boston, USA.
Kaufman
J A
JA
Fan
C M
CM
Geller
S C
SC
Brewster
D C
DC
Cambria
R P
RP
Lamuraglia
G M
GM
Gertler
J P
JP
Abbott
W M
WM
Waltman
A C
AC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001808:Blood Vessels / Q000637:transplantation*; D002081:Buttocks / Q000098:blood supply; D004621:Embolization, Therapeutic; D007172:Erectile Dysfunction / Q000209:etiology; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011183:Postoperative Complications; D003668:Pressure Ulcer / Q000209:etiology; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome