Early outcomes of iliac branch grafts in the endovascular repair of abdominal aortic aneurysms with concomitant bilateral common iliac artery aneurysms at a Japanese institution.
OBJECTIVE
Endovascular aneurysm repair (EVAR) is used to treat abdominal aortic aneurysms (AAAs) with bilateral common iliac artery aneurysms (CIAAs), and an interruption of the bilateral internal iliac arteries (IIAs) is often needed, which may cause postoperative ischemic complications. An iliac branch device (IBD) has thus been introduced as an endovascular technique to preserve the IIA flow. This study aimed to evaluate the technical feasibility and short-term results of using an IBD when treating AAA with bilateral CIAAs in a Japanese institution, where IBD use has still not been approved by the government.


METHODS
EVAR was performed using an IBD in six patients at high risk for open repair of an AAA with bilateral CIAAs.


RESULTS
Advanta V12 stent grafts were successfully placed in the IIA, bridging between the IIA and the IBD side branch from the contralateral iliac artery. Subsequently, EVAR was performed as usual. The technical success rate was 100 %. At the most recent follow-up (mean follow-up period, 14.2 months), all IBDs were patent. No patients complained of buttock claudication or ischemic colitis.


CONCLUSIONS
The implantation of an IBD during EVAR is technically feasible in Japanese AAA patients with bilateral CIAAs, and may be a viable method to avoid pelvic ischemic complications, such as intractable buttock claudication.
Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan, unno@hama-med.ac.jp.
Naoki
N
Unno
Naoto
N
Yamamoto
Kazunori
K
Inuzuka
Yuuki
Y
Mano
Masaki
M
Sano
Takaaki
T
Saito
Ryota
R
Sugisawa
Kazuto
K
Katahashi
Hiroyuki
H
Konno
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications* / Q000601:surgery*; D007083:Iliac Artery / Q000601:surgery*; D007511:Ischemia / Q000517:prevention & control; D007564:Japan; D008297:Male; D010388:Pelvis / Q000098:blood supply; D011183:Postoperative Complications / Q000517:prevention & control; D011474:Prosthesis Design; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome