title: Interventional exclusion of iliac artery aneurysms using the flow-diverting multilayer stent.
abstract: OBJECTIVE
  This study was designed to evaluate retrospectively the results of complex iliac artery aneurysm (IAA) exclusion using the Cardiatis-Multilayer-Stent.
  
  
  METHODS
  Between October 2010 and August 2012, ten IAAs were treated in eight males (mean age 75 (59-91) years) using the Multilayer Stent. All IAA exceeded a diameter of 3 cm or were symptomatic. Follow-up (FU) examinations included CT or MR angiography, sonography, and clinical assessment up to 2 years.
  
  
  RESULTS
  Primary stent placement was technically successful in eight of ten cases. In two cases, severe stent retraction during deployment necessitated placement of an additional stent. Immediately after stent placement, a marked reduction of flow within the sac was observed in all cases (peri-interventional mortality 0%). During FU, there were two thrombotic stent occlusions, making reintervention necessary (primary patency rate 80%, secondary patency 100%). Four IAA were completely occluded at FU, whereas the original vessel and covered branches (n = 8) were patent. In four IAA, there was still residual perfusion. In one patient, IAA diameter decreased slightly, while it remained constant in seven (mean imaging FU 195 (range 1-695) days). There were no adverse events on clinical FU (mean FU 467 (range 101-695) days).
  
  
  CONCLUSIONS
  Other studies showed the Cardiatis-Multilayer-Stent to be a technically relatively simple treatment option for complex IAA with inadequate landing zones, especially in patients with multiple comorbidities to avoid ipsilateral IIA obstruction. However, in our series complication rate was high. Incomplete sac exclusion, stent-shortening, and thrombotic occlusion can complicate treatment, making meticulous patient selection necessary. Close imaging surveillance is mandatory especially in the early postinterventional period.
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, Bonn, 53127, Germany. Claus.christian.pieper@ukb.uni-bonn.de
authors.forename: Claus Christian
authors.initials: CC
authors.lastname: Pieper
authors.forename: Carsten
authors.initials: C
authors.lastname: Meyer
authors.forename: Jens
authors.initials: J
authors.lastname: Rudolph
authors.forename: Frauke
authors.initials: F
authors.lastname: Verrel
authors.forename: Hans Heinz
authors.initials: HH
authors.lastname: Schild
authors.forename: Kai E
authors.initials: KE
authors.lastname: Wilhelm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D000792:Angiography / Q000379:methods; D001783:Blood Flow Velocity; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D015331:Cohort Studies; D057510:Endovascular Procedures / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015641:Radiography, Interventional / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome