Clinical implications of internal iliac artery embolization in endovascular repair of aortoiliac aneurysms.
To overcome constraints imposed by iliac artery anatomy, the anatomic inclusion criteria for endovascular aortic aneurysm repair can be extended by means of intentional coil occlusion of one or both internal iliac arteries and extension of the distal limb of the graft into an external iliac artery. We reviewed our experience with this intervention to determine the safety and efficacy of this approach to aneurysm repair. Over a 30-month period, 84 patients underwent endovascular abdominal aortic aneurysm repair; 23 underwent intentional unilateral (22) or bilateral (1) internal iliac artery occlusion. Morbidity, mortality, and long-term clinical outcomes were evaluated in these 23 patients. Patients were specifically questioned about exercise-induced buttock and extremity symptoms. Our results showed that intentional internal iliac artery embolization to allow endovascular repair of abdominal aortic aneurysms is accompanied by significant morbidity and should be approached with caution.
Lyden
S P
SP
Center for Vascular Disease, Strong Memorial Hospital, Divisions of Vascular Surgery and Interventional Radiology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 652, Rochester, NY 14642, USA.
Sternbach
Y
Y
Waldman
D L
DL
Green
R M
RM
D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D007083:Iliac Artery / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures