title: Use of the reversed Zenith iliac limb extension in the treatment of iliac artery aneurysms and various aortoiliac pathologies: outcome in midterm follow-up.
abstract: OBJECTIVE
  To report the midterm follow-up after treatment of various aortoiliac pathologies in an acute setting using reversed Zenith iliac limb extensions when appropriately sized stent-grafts were not available.
  
  
  METHODS
  From 2005 to 2007, 12 patients (10 men; mean age 71.5 ± 7.3 years) were treated with reversed Zenith iliac limb extensions for solitary iliac artery aneurysms (n = 8), an abdominal aortic aneurysm (AAA) in a small caliber aorta (n = 1), an anastomotic pseudoaneurysm in an aortobi-iliac graft (n = 1), a hypogastric artery aneurysm (n = 1), and a ruptured AAA secondary to a late type Ib endoleak after Talent stent-graft implantation (n = 1). The Zenith iliac limb extensions were deployed on the back table and reloaded in a reversed manner to treat aneurysms and other lesions with a broad range of different diameter necks and landing zones.
  
  
  RESULTS
  The technical success rate was 100%, and no endoleaks were present at the end of the procedures. The endoleak patient with the ruptured AAA died owing to respiratory insufficiency. The other 11 patients have a mean follow-up of 29±9 months. In this period, 2 patients received a femorofemoral crossover bypass because of an occluded iliac limb extension. One patient had a type II endoleak without growth of the iliac aneurysm. Two patients died of a ruptured 4.4-cm AAA at 16 months and of respiratory insufficiency due to metastases at 47 months, respectively.
  
  
  CONCLUSIONS
  When necessary, it is feasible to use a revered Zenith limb extension to treat solitary iliac aneurysms and other aortoiliac pathologies, achieving satisfactory midterm outcomes.
authors.affiliation: Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands. n.peppelenbosch@mumc.nl
authors.forename: Arnoud G
authors.initials: AG
authors.lastname: Peppelenbosch
authors.forename: Michiel W
authors.initials: MW
authors.lastname: de Haan
authors.forename: Jan-Willem H C
authors.initials: JW
authors.lastname: Daemen
authors.forename: Geert W H
authors.initials: GW
authors.lastname: Schurink
mesh_terms: D000783:Aneurysm / Q000601:surgery*; D017541:Aneurysm, False / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D057867:Endoleak; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017543:Iliac Aneurysm / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures