title: Risk Factor Analysis for Buttock Claudication after Internal Iliac Artery Embolization with Endovascular Aortic Aneurysm Repair.
abstract: OBJECTIVE
  Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) involving the common iliac artery requires extension of the stent-graft limb into the external iliac artery. For this procedure, internal iliac artery (IIA) embolization is performed to prevent type II endoleak. In this study, we investigated the frequency and risk factor of buttock claudication (BC) in patients having interventional embolization of the IIA.
  
  
  METHODS
  From January 2010 to December 2013, a total of 110 patients with AAA were treated with EVAR in our institution. This study included 27 patients (24.5%) who had undergone unilateral IIA coil embolization with EVAR. We examined hospital charts retrospectively and interviewed by telephone for the occurrence of BC.
  
  
  RESULTS
  Mean age of total patients was 71.9±7.0 years and 88.9% were males. During a mean follow-up of 8.65±9.04 months, the incidence of BC was 40.7% (11 of 27 patients). In 8 patients with claudication, the symptoms had resolved within 1 month of IIA embolization, but the symptoms persisted for more than 6 months in the remaining 3 patients. In univariate and multivariate analysis, risk factors such as age, sex, comorbidity, patency of collateral arteries, and anatomical characteristics of AAA were not significantly related with BC.
  
  
  CONCLUSIONS
  In this study, BC was a frequent complication of IIA embolization during EVAR and there was no associated risk factor. Certain principles such as checking preoperative angiogram, proximal and unilateral IIA embolization may have contributed to reducing the incidence of BC.
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Daegu Catholic University College of Medicine, Daegu, Korea.
authors.forename: Hye Ryeon
authors.initials: HR
authors.lastname: Choi
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Daegu Catholic University College of Medicine, Daegu, Korea.
authors.forename: Ki Hyuk
authors.initials: KH
authors.lastname: Park
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Daegu Catholic University College of Medicine, Daegu, Korea.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
keywords: Abdominal aortic aneurysm; Intermittent claudication; Risk factors; Therapeutic embolization