title: Initial Experience in the Treatment of Extensive Iliac Artery Aneurysms With the Nellix Aneurysm Sealing System.
abstract: OBJECTIVE
  To assess the feasibility and effectiveness of the Nellix prosthesis in the treatment of common iliac artery aneurysms.
  
  
  METHODS
  Between May 2013 and June 2015, 230 patients underwent implantation of the Nellix device at 2 institutions. Fifty of these patients (mean age 76 years; 35 men) were identified as having 60 common iliac artery aneurysms (CIAAs) with a median diameter of 4 cm (range 3.5-7). The majority of patients had aortoiliac aneurysms (5, 70%), 10 (20%) had isolated CIAAs, and 5 (10%) had iliac anastomotic aneurysms after aortoiliac bypass. In 20 patients, the iliac aneurysm was the indication for the intervention; in the other 30 patients, the endovascular iliac repair was an adjunct procedure to endovascular aneurysm sealing (EVAS). An iliac branch device (IBD) was used when feasible to preserve flow to the internal iliac artery.
  
  
  RESULTS
  Seventeen (34%) patients underwent elective implantation of the Nellix graft in combination with an IBD, 33 (66%) patients underwent Nellix sealing of the CIAA using 1 (n=5), 2 (n=22), or 3 Nellix grafts (2 bilateral grafts and 1 graft as an extension to the external iliac artery in 6 patients). The technical success rate was 100%, and no graft-related complications were reported postoperatively. No buttock claudication, reinterventions, graft thrombosis, or endoleaks were observed during a mean follow-up of 12 months.
  
  
  CONCLUSIONS
  Our initial experience demonstrates that Nellix grafts are feasible and safe for the treatment of extensive iliac artery aneurysms. The long-term durability of these grafts should be validated in larger patient cohorts before this promising alternative endovascular technique can gain widespread acceptance.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Medical Center of the Johannes Gutenberg-University Mainz, Germany marwanjousef@yahoo.com.
authors.forename: Marwan
authors.initials: M
authors.lastname: Youssef
authors.affiliation: Department of Vascular Surgery, Hospital of Augsburg, Germany.
authors.forename: Zmarai
authors.initials: Z
authors.lastname: Nurzai
authors.affiliation: Department of Vascular Surgery, Hospital of Augsburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Zerwes
authors.affiliation: Department of Vascular Surgery, Hospital of Augsburg, Germany.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Jakob
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Medical Center of the Johannes Gutenberg-University Mainz, Germany.
authors.forename: Fritz
authors.initials: F
authors.lastname: Dünschede
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Medical Center of the Johannes Gutenberg-University Mainz, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Dorweiler
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Medical Center of the Johannes Gutenberg-University Mainz, Germany.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Vahl
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012039:Regional Blood Flow; D015607:Stents; D016896:Treatment Outcome
keywords: anastomotic aneurysm; aortoiliac aneurysm; common iliac artery aneurysm; endovascular aneurysm sealing; iliac branch device; internal iliac artery