Endovascular treatment of iliac artery aneurysms with a tubular stent-graft: mid-term results.
OBJECTIVE
To report the mid term results of a prospective cohort of iliac artery aneurysms (IAAs) treated with endovascular tubular stent-grafts.


METHODS
All IAAs referred to the University Medical Center Groningen between June 1998 and June 2005 were evaluated for endovascular repair. Criteria for repair were a diameter of > or = 30 mm for anastomotic aneurysms and > or = 35 mm for true aneurysms. Preferentially, tubular grafts were used. Follow-up included both radiographs of the abdomen and duplex examination.


RESULTS
In 35 patients, 40 IAAs were treated endovascularly with a tubular stent-graft. Elective repair was performed in 30 patients (86%) and emergent repair in five patients (14%). Aneurysms were false in 26 cases (65%) and true in 14 cases (35%). Local anesthesia was used in 74% of the cases. The stent-grafts that were used included the Excluder contralateral limb (n = 28, 70%), Passager (n = 9, 22.5%), Hemobahn (n = 2, 5%), and Wallgraft (n = 1, 2.5%). The mean operation time was 83 +/- 28 minutes (range, 50 to 150 minutes). Mean hospital stay was 3.3 +/- 2.3 days (range, 1 to 12 days). There was no 30-day mortality. Patients were followed up for a mean of 31.2 +/- 20.7 months (range, 3 to 83 months). Complications occurred in two patients during follow-up, including migration with a proximal type I endoleak in one, and occlusion of the stent-graft in the other. The internal iliac artery was intentionally sacrificed in 28 patients (70%), and this led to gluteal claudication in three patients.


CONCLUSIONS
Endovascular repair of iliac artery aneurysms with flexible stent-grafts is a minimally invasive technique and is associated with low mortality and morbidity. Follow-up results up to 5 years suggest that the technique is durable. It should be regarded as a first choice treatment option for suitable aneurysms.
Tielliu
Ignace F J
IF
Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Netherlands. i.tielliu@chir.umcg.nl
Verhoeven
Eric L G
EL
Zeebregts
Clark J
CJ
Prins
Ted R
TR
Oranen
Björn I
BI
van den Dungen
Jan J A M
JJ
D000368:Aged; D017541:Aneurysm, False / Q000601:surgery; D001807:Blood Vessel Prosthesis; D017558:Elective Surgical Procedures; D004630:Emergencies; D005500:Follow-Up Studies; D006801:Humans; D017543:Iliac Aneurysm / Q000601:surgery*; D007902:Length of Stay; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D015607:Stents; D016896:Treatment Outcome