title: Endovascular Treatment of Common Iliac Artery Aneurysms With an Iliac Branch Device: Multicenter Experience of 140 Patients.
abstract: To evaluate the efficacy, feasibility, and long-term outcomes of the Zenith ZBIS iliac branch device (IBD) to preserve internal iliac artery (IIA) perfusion in a large Dutch multicenter cohort.
  
  
  
  Between September 2004 and August 2015, 140 patients (mean age 70.9±7.4 years; 130 men) with 162 IBD implantations were identified in 7 vascular centers. The indication for IBD implantation was an abdominal aortic aneurysm >55 mm with a concomitant common iliac artery (CIA) aneurysm >20 mm (n=40), a CIA aneurysm with a diameter >30 mm (n=89), or revision of a type Ib endoleak after endovascular aneurysm repair (n=11).
  
  
  
  Technical success (aneurysm exclusion, no type I or III endoleak, and a patent IIA) was obtained in 157 (96.9%) of 162 IBD implantations. Six (4.3%) patients developed major complications; 2 (1.4%) died. Mean follow-up was 26.6±24.1 months, during which 17 (12.1%) IBD-associated secondary interventions were performed. Including technical failures and intentional IIA embolizations, 15 (9.3%) IIA branch occlusions were identified; buttock claudication developed in 6 of these patients. The freedom from secondary intervention estimate was 75.9% (95% confidence interval 59.7 to 86.3) at 5 years.
  
  
  
  CIA aneurysms can be treated safely and effectively by IBDs with preservation of antegrade flow to the IIA. Secondary interventions are indicated in >10% of patients during follow-up but can be performed endovascularly in most.
authors.affiliation: 1 Department of Vascular Surgery, Maasstad Hospital, Rotterdam, the Netherlands.
authors.forename: Hidde
authors.initials: H
authors.lastname: Jongsma
authors.affiliation: 1 Department of Vascular Surgery, Maasstad Hospital, Rotterdam, the Netherlands.
authors.forename: Joost A
authors.initials: JA
authors.lastname: Bekken
authors.affiliation: 1 Department of Vascular Surgery, Maasstad Hospital, Rotterdam, the Netherlands.
authors.forename: Wouter J J
authors.initials: WJ
authors.lastname: Bekkers
authors.affiliation: 2 Department of Vascular Surgery, University Medical Center, Groningen, the Netherlands.
authors.forename: Clark J
authors.initials: CJ
authors.lastname: Zeebregts
authors.affiliation: 3 Department of Vascular Surgery, University Medical Center, Utrecht, the Netherlands.
authors.forename: Joost
authors.initials: J
authors.lastname: van Herwaarden
authors.affiliation: 4 Department of Vascular Surgery, Vrije Universiteit Medical Center, Amsterdam, the Netherlands.
authors.forename: Arjan
authors.initials: A
authors.lastname: Hoksbergen
authors.affiliation: 5 Department of Vascular Surgery, Catharina Hospital, Eindhoven, the Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: Cuypers
authors.affiliation: 6 Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, the Netherlands.
authors.forename: Jean Paul P M
authors.initials: JP
authors.lastname: de Vries
authors.affiliation: 7 Department of Vascular Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Hence J
authors.initials: HJ
authors.lastname: Verhagen
authors.affiliation: 1 Department of Vascular Surgery, Maasstad Hospital, Rotterdam, the Netherlands.
authors.forename: Bram
authors.initials: B
authors.lastname: Fioole
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D004621:Embolization, Therapeutic; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D011474:Prosthesis Design; D012039:Regional Blood Flow; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
keywords: abdominal aortic aneurysm; branch occlusion; branched stent-graft; common iliac artery aneurysm; complications; endoleak; endovascular aneurysm repair; hypogastric artery; iliac artery; internal iliac artery; mortality; reintervention