Endovascular repair of isolated iliac artery aneurysms.
OBJECTIVE
To retrospectively evaluate a 12-year experience with endovascular repair of isolated iliac artery aneurysm (IAA).


METHODS
From August 1997 through July 2009, 91 patients (81 men; mean age 71 years, range 31-90) underwent endovascular treatment for isolated IAA at our department. Of these, 77 patients received stent-grafts either alone or in combination with coils or an Amplatzer vascular plug (n = 2); 1 patient received a Smart stent combined with coils, and 13 patients were treated with coil embolization only. The aneurysms were classified according to location: type I = common iliac artery (CIA), type II = internal iliac artery (IIA), type III = CIA and IIA, and type IV = external iliac artery with/without CIA and/or IIA involvement.


RESULTS
Primary technical success was 90.1% for all aneurysm types and 93.6%, 80%, 88.8%, and 93.3% for types I, II, III, and IV, respectively. Secondary technical success was 96.7% for all types and 97.8%, 95%, 100%, and 93.3%, respectively, for each type. Clinical success was 93.4% for all types and 97.8%, 85%, 100%, and 86.7%, respectively, by type. Complications in 18 (19.8%) patients included 7 type I endoleaks, 3 type II endoleaks, 2 enlarged aneurysm sacs (incomplete embolization), 5 cases of buttock claudication, and 2 stent-graft thromboses. Two patients were converted to open surgery; 10 underwent secondary interventions. Mortality rates were 1.1% (n = 1) at 30 death days and 23.1% (n = 21) over a mean follow-up of 45.9 months (no aneurysm-related death). Cumulative overall survival was 97.7% at 1 year and 47.6% at 10 years. Freedom from aneurysm-related complications was 88.6% at 1 year and 83.5% at 5 years.


CONCLUSIONS
Endovascular repair of isolated IAA is a safe and minimally invasive alternative to surgery. However, it may be associated with several complications and must, therefore, be carefully planned.
Chemelli
Andreas
A
Departments of Radiology, Innsbruck Medical University, Innsbruck, Austria.
Hugl
Beate
B
Klocker
Josef
J
Thauerer
Michael
M
Strasak
Alexander
A
Jaschke
Werner
W
Waldenberger
Peter
P
Chemelli-Steingruber
Iris Eva
IE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D015607:Stents; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome