title: Another late complication after endovascular aneurysm repair: aneurysmal degeneration at the iliac artery landing site.
abstract: The purpose of this article is to describe a hitherto underreported late complication of infrarenal endovascular aneurysm repair (EVAR), namely type Ib endoleakage resulting from aneurysmal degeneration at the iliac artery landing site. In a prospectively recorded audit, between 1994 and 2007, 297 patients underwent EVAR. All cases that developed iliac artery aneurysm (IAA) were studied. Ten cases of IAA in seven patients (2.4% of the cohort) developed 5 to 9 years after EVAR. Eight of the 10 involved the lower landing site of the stent graft. Landing site diameter before EVAR was 12 mm (range 10-15 mm). Three IAAs presented as emergencies with rapidly expanding sacs and impending rupture. All cases underwent further endovascular intervention with no < 30-day mortality. Iliac artery landing site aneurysm formation after EVAR occurs uncommonly after 5 or more years. It should be regarded as an indication for intervention prior to type Ib endoleakage development. The need for lifelong surveillance is highlighted.
authors.affiliation: Endovascular Unit, University College Hospital, London, UK.
authors.forename: Obekieze
authors.initials: O
authors.lastname: Agu
authors.forename: Dee
authors.initials: D
authors.lastname: Boardley
authors.forename: Mohan
authors.initials: M
authors.lastname: Adiseshiah