title: Use of iliac branch devices for endovascular repair of aneurysmal distal seal zones after EVAR.
abstract: OBJECTIVE
  To assess the feasibility and midterm outcomes of iliac branch devices (IBD) for the treatment of aneurysmal distal seal zones after endovascular aneurysm repair (EVAR).
  
  
  METHODS
  Between January 2005 and January 2014, 188 patients with aortic aneurysms involving the iliac bifurcation underwent IBD implantation; of these, 18 consecutive patients (17 men; mean age 70±10 years) were treated for aneurysmal degeneration of 22 distal seal zones (mean 36±6-mm diameter) after EVAR. The main outcome measure was technical success. Further outcomes were primary and assisted primary patency of the internal iliac branch, types Ib/III endoleaks, reintervention, and all-cause mortality.
  
  
  RESULTS
  The technical success rate was 100%. The primary patency rate was 100% over a median follow-up of 15 months (interquartile range 4-25). None of the patients developed type Ib or III endoleak. During surveillance, two device-related reinterventions were performed (thrombectomy of an occluded external iliac artery and angioplasty with stenting of a stenotic common iliac artery). One patient died due to metastatic prostate cancer.
  
  
  CONCLUSIONS
  Iliac side branch endografting showed excellent feasibility and encouraging midterm outcomes for the challenging endovascular repair of aneurysmal distal seal zones post EVAR.
authors.affiliation: Department of Vascular Surgery, St. Franziskus Hospital and University Clinic of Münster, Germany.
authors.forename: Theodosios
authors.initials: T
authors.lastname: Bisdas
authors.forename: Kristin
authors.initials: K
authors.lastname: Weiss
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Donas
authors.forename: Arne
authors.initials: A
authors.lastname: Schwindt
authors.forename: Giovanni
authors.initials: G
authors.lastname: Torsello
authors.forename: Martin
authors.initials: M
authors.lastname: Austermann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D018572:Disease-Free Survival; D057867:Endoleak / Q000209:etiology / Q000628:therapy; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D019233:Retreatment; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: aneurysmal dilatation; common iliac artery aneurysm; distal seal zone; endovascular aneurysm repair; iliac branch device