title: Occlusion of the common and internal iliac arteries for aortoiliac aneurysm repair: experience with the Amplatzer vascular plug.
abstract: BACKGROUND
  We sought to evaluate and describe our centre's experience with the Amplatzer vascular plug (AVP) for the occlusion of common and internal iliac arteries (CIA; IIA) during endovascular aortic aneurysm repair (EVAR).
  
  
  METHODS
  We performed a retrospective analysis of 20 consecutive patients between October 2006 and December 2007, who underwent occlusion of the CIA or IIA before or during EVAR to prevent endoleak.
  
  
  RESULTS
  Among these 20 patients, 21 occlusion procedures occurred and 20 were successful. In the only unsuccessful case, the patient had EVAR, but occlusion with an AVP was not possible because of severe narrowing at the origin of the vessel. Of the successfully treated patients, 2 presented with ruptured aneurysms, whereas the others had elective procedures. Eleven patients received aortouni-iliac grafts and femoral-femoral bypass, and 9 patients received a bifurcated stent graft. In 5 patients, the AVP occlusion and EVAR procedures were staged; in these cases occlusion occurred first, followed by EVAR on average 29 (standard deviation [SD] 23) days later. We deployed 7 AVPs in the CIA, whereas 13 were deployed in the IIA. The average diameter of the vessels occluded was 10 (SD 1) mm and the average size of the device used was 13 (SD 1) mm, representing a device diameter 28% (SD 2%) greater than the vessel diameter. We used a single device in 18 patients, whereas 2 devices were deployed in the same artery in 2 patients. Four patients underwent concomitant coil embolization. On follow-up computed tomography (CT) scans, all occlusion procedures were clinically successful. At the 14-month (SD 1 mo) follow-up, 4 patients had a small type-II endoleak unrelated to the occlusion procedure and 1 had a type-I endoleak that required graft limb extension. Four patients had buttock claudication but none had changes in sexual function, ischemic complications or device dislodgement on CT scans.
  
  
  CONCLUSIONS
  The AVP is a safe and effective method to occlude the CIA and IIA in patients undergoing EVAR.
authors.affiliation: Division of Vascular Surgery St. Paul's Hospital, University of British Columbia, Vancouver, BC.
authors.forename: S Marlene
authors.initials: SM
authors.lastname: Grenon
authors.forename: Joel
authors.initials: J
authors.lastname: Gagnon
authors.forename: York
authors.initials: Y
authors.lastname: Hsiang
authors.forename: Ravi
authors.initials: R
authors.lastname: Sidhu
authors.forename: David
authors.initials: D
authors.lastname: Taylor
authors.forename: Jason
authors.initials: J
authors.lastname: Clement
authors.forename: Jerry
authors.initials: J
authors.lastname: Chen
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome