title: Technical considerations and performance of bridging stent-grafts for iliac side branched devices based on a pooled analysis of single-center experiences.
abstract: OBJECTIVE
  To report a pooled analysis of single-center experiences designed to determine the performance of self-expanding vs. balloon-expandable bridging stent-grafts used in iliac branch devices (IBDs) for the repair of iliac artery aneurysms.
  
  
  METHODS
  The English-language literature in the MEDLINE and EMBASE databases was searched for articles published between 2006 and 1 March 2012 on the performance of bridging stent-grafts in the internal iliac artery. Studies were eligible for the analysis if they contained the type of bridging stent-grafts used and the time and cause of any occlusion of the bridging devices. Eight of the 13 studies published between 2006 and 2011 fulfilled the eligibility criteria. The outcome measure was the patency of bridging stent-grafts defined as absence of occlusion of the side branch in the internal iliac artery. Additionally, the performance of the self-expanding stent-grafts vs. balloon-expandable stent-grafts used in conjunction with the IBDs was compared.
  
  
  RESULTS
  In the 8 studies, 100 (42%) self-expanding stent-grafts and 136 (58%) balloon-expandable stent-grafts were placed in 185 patients. Of these 236 bridging stent-grafts, 15 (6%) occluded in 13 (7%) patients: 10 within 30 days after the intervention [2 (1.5%) balloon-expandable and 8 (8%) self-expanding stent-grafts] and 5 beyond 30 days [2 (1.5%) balloon-expandable and 3 (3%) self-expanding stent-grafts]. Symptomatic presentation (hip and/or buttock claudication) of the occluded iliac branch was recorded in 7 of the 13 patients.
  
  
  CONCLUSIONS
  The current literature does not support robust conclusions about the performance of bridging endografts of IBDs due to the heterogeneity of the studies. However, the occlusion rate of the bridging stent-grafts was low, especially for balloon-expandable stent-grafts compared to self-expanding devices.
authors.affiliation: Department of Vascular Surgery, St. Franziskus Hospital Münster, and Clinic for Vascular and Endovascular Surgery, Münster University Hospital, Münster, Germany. k.donas@gmx.at
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Donas
authors.forename: Theodosios
authors.initials: T
authors.lastname: Bisdas
authors.forename: Giovanni
authors.initials: G
authors.lastname: Torsello
authors.forename: Martin
authors.initials: M
authors.lastname: Austermann
mesh_terms: D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D017543:Iliac Aneurysm / Q000503:physiopathology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D011474:Prosthesis Design; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency