title: Endovascular Aneurysm Repair Treatment of Aortoiliac Aneurysms: Can Iliac Branched Devices Prevent Gluteal Claudication?
abstract: OBJECTIVE
  To compare the risk of gluteal claudication after endovascular aneurysm repair (EVAR) of aortoiliac aneurysms by interventional exclusion of the internal iliac artery (IIA) with plugs or coils versus a branch iliac device to maintain pelvic blood supply and to identify risk factors for postoperative gluteal claudication.
  
  
  METHODS
  A retrospective analysis of a prospectively collected data set included patients with aortoiliac aneurysms treated with EVAR from January 2007 to December 2013 at a tertiary referral vascular unit. Descriptive and procedural data were obtained from a database of prospectively enrolled patients. Medical records of 112 consecutive patients treated with EVAR were scrutinized for graft-related adverse events and pelvic ischemia. The occurrence of gluteal claudication was determined from medical records.
  
  
  RESULTS
  Iliac occlusion was performed in 115 limbs, and a branch iliac device was placed in 25 limbs. Gluteal claudication developed in 38% of limbs treated with IIA exclusion but in none of the limbs treated with branch iliac devices (P < .001). Procedure time, fluoroscopy time, and use of iodine contrast material did not differ between the two groups. The incidence of gluteal claudication was higher when coils rather than plugs were used for embolization of the IIA before EVAR (P = .002).
  
  
  CONCLUSIONS
  The findings suggest that the use of a branch iliac device significantly reduces the risk of gluteal claudication after EVAR of aortoiliac aneurysm.
authors.affiliation: Department of Radiology, Rigshospitalet and University of Copenhagen, and the Center for Clinical Education, Capital Region and University of Copenhagen, Copenhagen, Denmark. Electronic address: mikkeltaudorf@gmail.com.
authors.forename: Mikkel
authors.initials: M
authors.lastname: Taudorf
authors.affiliation: Department of Radiology, Rigshospitalet and University of Copenhagen, and the Center for Clinical Education, Capital Region and University of Copenhagen, Copenhagen, Denmark.
authors.forename: John
authors.initials: J
authors.lastname: Grønvall
authors.affiliation: Department of Radiology Vascular Surgery, Rigshospitalet and University of Copenhagen, and the Center for Clinical Education, Capital Region and University of Copenhagen, Copenhagen, Denmark.
authors.forename: Torben V
authors.initials: TV
authors.lastname: Schroeder
authors.affiliation: Department of Radiology, Rigshospitalet and University of Copenhagen, and the Center for Clinical Education, Capital Region and University of Copenhagen, Copenhagen, Denmark; Department of Radiology Vascular Surgery, Rigshospitalet and University of Copenhagen, and the Center for Clinical Education, Capital Region and University of Copenhagen, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Lönn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D002081:Buttocks / Q000098:blood supply*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D017543:Iliac Aneurysm / Q000628:therapy*; D007383:Intermittent Claudication / Q000517:prevention & control*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D055989:Septal Occluder Device; D016896:Treatment Outcome