title: Occlusion of the internal iliac artery prior EVAR: comparison of coils and plugs.
abstract: OBJECTIVE
  We compared occlusion of the internal iliac artery (IIA) using coils or the Amplatzer vascular plug (AVP) II prior to endovascular aortic aneurysm repair.
  
  
  METHODS
  Occlusion of the IIA was performed in 32 patients (aged 74 ± 8 years) using coils (N = 17) or the AVP II (N = 15). We retrospectively compared procedural data, initial success, and clinical outcome in a 12-month follow-up.
  
  
  RESULTS
  Occlusion was successful in all patients without detection of an endoleak after 12 months. Procedure time and fluoroscopy time for coils versus plugs were 77 ± 35 versus 43 ± 13 minutes and 36 ± 19 versus 18 ± 8 minutes, respectively (P < .003). Incidence of initial buttock claudication (BC) for coils versus plugs was 47% versus 27% and was significantly more severe after coil occlusion (P = .03). After a 12-month follow-up, 2 patients of each group reported of mild BC.
  
  
  CONCLUSIONS
  Occlusion of the IIA is safe and effective using coils or plugs. Initial BC is significantly more severe when coils are used, but after a 12-month follow-up, there is no significant difference. Using a plug is associated with a significant reduction of procedure time and radiation exposure.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Deaconess Hospital, Schwäbisch Hall, Germany. martin.libicher@urz.uni-heidelberg.de
authors.forename: Martin
authors.initials: M
authors.lastname: Libicher
authors.forename: Daphne
authors.initials: D
authors.lastname: Pavlidis
authors.forename: Christopher
authors.initials: C
authors.lastname: Bangard
authors.forename: Michael
authors.initials: M
authors.lastname: Gawenda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000191:economics / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000191:economics; D002081:Buttocks / Q000098:blood supply; D016009:Chi-Square Distribution; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000191:economics; D004867:Equipment Design; D005858:Germany; D017721:Hospital Costs; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000191:economics / Q000503:physiopathology / Q000628:therapy*; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D007383:Intermittent Claudication / Q000209:etiology; D008875:Middle Aged; D016017:Odds Ratio; D015641:Radiography, Interventional; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome