Outcome of proximal internal iliac artery coil embolization prior to stent-graft extension in patients previously treated by endovascular aortic repair.
OBJECTIVE
To assess the safety, feasibility, and effectiveness of coil embolization of the proximal internal iliac artery (IIA) before stent-graft extension in patients previously treated by endovascular aortic repair (EVAR).


METHODS
Over a period of 9 years, 16 ipsilateral, proximal IIA coil embolization procedures were performed before stent-graft extension in 13 patients previously treated by a modular aortic stent graft. Indication for coil embolization and concomitant stent-graft extension were secondary (ie, late) distal type I endoleak (n = 9) and late onset of an isolated common iliac artery aneurysm (n = 7) as a result of increasing dilation of a common iliac artery during follow-up after EVAR; mean common iliac artery diameter before coil embolization was 26.1 mm (range, 15-35 mm). Clinical and radiologic follow-up (mean, 39 months; range, 6-102 months) was done in accordance with an established registry.


RESULTS
All procedures were successful except for one performed with 0.035-inch coils. Clinically, buttock claudication was noted in five of 13 patients (38%). No type II endoleak occurred through the coil-embolized internal iliac arteries. The mean common iliac artery diameter at 6-month follow-up was 23.0 mm (range, 14-30 mm; P = .0005).


CONCLUSIONS
Ipsilateral coil or microcoil embolization of the proximal IIA before stent-graft extension in patients previously treated by an aortic stent graft seems to be safe and feasible, with favorable outcomes after a mean follow-up of 39 months.
Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. geert.maleux@uzleuven.be
Geert
G
Maleux
Endry
E
Willems
Johan
J
Vaninbroukx
André
A
Nevelsteen
Sam
S
Heye
D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome