title: Buttock claudication after interventional occlusion of the hypogastric artery--a mid-term follow-up.
abstract: BACKGROUND
  Interventional occlusion of the hypogastric artery (HA) can be used for endovascular aneurysm repair (EVAR) in the iliac arteries. Most frequent ischemic complication is buttock claudication (BC).
  
  
  OBJECTIVE
  To investigate the frequency and progression of BC after interventional occlusion of the HA prior to EVAR.
  
  
  METHODS
  A retrospective analysis was performed in patients with EVAR and occlusion of the HA between September 2004 and August 2010. Acute and persistent BC symptoms were assessed.
  
  
  RESULTS
  Fifty-four catheter occlusions of the HA were performed. In 10 cases, claudication could not be evaluated. During a mean follow-up of 17 months, 23 occlusions (52.3%) of the HA showed BC, in 52% symptoms were persistent. Of the 5 patients, 3 patients who underwent bilateral occlusion had BC and in 2 cases, persistent in the follow-up.
  
  
  CONCLUSIONS
  Buttock claudication after occlusion of the HA prior to EVAR is a frequent complication, which often persists during follow-up. Alternatives that maintain pelvic perfusion should be considered.
authors.affiliation: Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Kerpener Str 62, 50937 Cologne, Germany. daphne.pavlidis@uk-koeln.de
authors.forename: Daphne
authors.initials: D
authors.lastname: Pavlidis
authors.forename: M
authors.initials: M
authors.lastname: Hörmann
authors.forename: M
authors.initials: M
authors.lastname: Libicher
authors.forename: M
authors.initials: M
authors.lastname: Gawenda
authors.forename: J
authors.initials: J
authors.lastname: Brunkwall
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000401:mortality; D002081:Buttocks / Q000098:blood supply*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D005858:Germany; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D007383:Intermittent Claudication / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply*; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome