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Overstenting the hypogastric artery during endovascular aneurysm repair with and without prior coil embolization: A comparative analysis from the ENGAGE Registry. J Vasc Surg 2018; 67:134-141. [DOI: 10.1016/j.jvs.2017.04.061] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 04/29/2017] [Indexed: 01/18/2023]
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Bosanquet D, Wilcox C, Whitehurst L, Cox A, Williams I, Twine C, Bell R, Bicknell C, Coughlin P, Hayes P, Jenkins M, Vallabhaneni S. Systematic Review and Meta-analysis of the Effect of Internal Iliac Artery Exclusion for Patients Undergoing EVAR. Eur J Vasc Endovasc Surg 2017; 53:534-548. [DOI: 10.1016/j.ejvs.2017.01.009] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 01/15/2017] [Indexed: 12/13/2022]
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Dierks A, Sauer A, Wolfschmidt F, Hassold N, Kellersmann R, Bley TA, Kickuth R. Proximal occlusion of unaffected internal iliac artery versus distal occlusion of aneurysmatic internal iliac artery prior to EVAR: a comparative evaluation of efficacy and clinical outcome. Br J Radiol 2017; 90:20160527. [PMID: 28256907 DOI: 10.1259/bjr.20160527] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Occlusion of the internal iliac artery (IIA) may be necessary prior to endovascular aneurysm repair (EVAR) to prevent endoleak Type II. We compared efficacy and clinical outcome after proximal occlusion of an unaffected IIA (ProxEmbx) using an Amplatzer vascular plug (AVP) I vs distal occlusion of aneurysmatic IIA with coils and plugs (DistEmbx). METHODS Between 2009 and 2012, 22 patients underwent EVAR. In 9 patients with unaffected IIA, occlusion was performed by a single AVP. In 13 patients with aneurysmatic IIA, more distal embolization (DistEmbX) was conducted by using several coils and additional AVPs. Retrospectively, technical success, clinical outcome and complications were evaluated. RESULTS Embolization of the IIA was successful in all patients. Three patients with more DistEmbX of aneurysmatic IIAs suffered from new onset of sexual dysfunction after occlusion without statistically significant difference (p > 0.05). Transient buttock claudication was observed in three patients in each group. Bowel ischaemia did not occur. The procedure time (p = 0.013) and fluoroscopy time (p = 0.038) was significantly lower in the ProxEmbx group than in the DistEmbx group. CONCLUSION Proximal occlusion of an unaffected IIA and more distal occlusion of an aneurysmatic IIA prior to EVAR had the same technical and clinical outcome. However, proximal plug embolization of an unaffected IIA prior to EVAR was associated with shorter procedure and fluoroscopy time in comparison with more DistEmbX of aneurysmatic IIAs. Advances in knowledge: Proximal embolization of unaffected IIA and DistEmbX of aneurysmatic IIA before EVAR are both effective in preventing Type II endoleaks and have the same technical and clinical outcome.
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Affiliation(s)
- Alexander Dierks
- 1 Department of Diagnostic and Interventional Radiology, University Hospital of Wuerzburg, Würzburg, Germany
| | - Alexander Sauer
- 1 Department of Diagnostic and Interventional Radiology, University Hospital of Wuerzburg, Würzburg, Germany
| | - Franziska Wolfschmidt
- 1 Department of Diagnostic and Interventional Radiology, University Hospital of Wuerzburg, Würzburg, Germany
| | - Nicole Hassold
- 1 Department of Diagnostic and Interventional Radiology, University Hospital of Wuerzburg, Würzburg, Germany
| | - Richard Kellersmann
- 2 Department of General, Visceral, Vascular and Paediatric Surgery, University of Wuerzburg, Würzburg, Germany
| | - Thorsten A Bley
- 1 Department of Diagnostic and Interventional Radiology, University Hospital of Wuerzburg, Würzburg, Germany
| | - Ralph Kickuth
- 1 Department of Diagnostic and Interventional Radiology, University Hospital of Wuerzburg, Würzburg, Germany
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Fujioka S, Hosaka S, Morimura H, Chen K, Wang ZC, Toguchi K, Fukuda S, Takizawa K, Osawa H. Outcomes of Extended Endovascular Aortic Repair for Aorto-Iliac Aneurysm with Internal Iliac Artery Occlusion. Ann Vasc Dis 2017. [PMID: 29515696 PMCID: PMC5835440 DOI: 10.3400/avd.oa.17-00089] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Patients of aorto-iliac aneurysms who undergo endovascular aortic repair (EVAR) require internal iliac artery (IIA) occlusion with coil embolization and its coverage with the stent graft to prevent type II endoleak after extending the endograft into the external iliac artery. However, it has become well recognized that IIA occlusion cause buttock claudication and other various sequelae due to pelvic ischemia. We retrospectively analyzed IIA occlusion outcomes. Methods: From October 2008 to February 2015, 71 patients with aorto-iliac aneurysms underwent IIA occlusion prior to EVAR. The relationship between pelvic circulation and symptom of pelvic ischemia was studied. Results: Buttock claudication occurred in 17 patients (22.9%) of all. Eight patients (14.8%) in unilateral IIA occlusion group (54 patients) and nine patients (52.9%) in bilateral IIA group (17 patients) had sequelae of claudication. The sacrifice of the communication of superior gluteal artery (SGA) and inferior gluteal artery (IGA) led to buttock claudication in 18 (64.3%) of 28 limbs. Instead, only 4 of 60 limbs had buttock claudication, when we preserved the communication between SGA and IGA. In all patients, staged treatment of aorto-iliac aneurysms with IIA occlusion and EVAR were done successfully without pelvic ischemic complications except for buttock claudication, and postoperative CT scanning showed no endoleakage. Conclusion: IIA occlusion prior to EVAR is recognized as a safe and reasonable strategy. It is emphasized that preservation of the communication of SGA and IGA is important to prevent buttock claudication. (This is a translation of Jpn J Vasc Surg 2016; 25: 240–245.)
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Affiliation(s)
- Shunichiro Fujioka
- Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shigeru Hosaka
- Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hayato Morimura
- Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ken Chen
- Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Zhi Chao Wang
- Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koji Toguchi
- Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shoji Fukuda
- Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koki Takizawa
- Department of Cardiovascular Surgery, Shimada General Hospital, Choshi, Chiba, Japan
| | - Hiroshi Osawa
- Department of Cardiovascular Surgery, Shimada General Hospital, Choshi, Chiba, Japan
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5
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Kontopodis N, Tavlas E, Papadopoulos G, Galanakis N, Tsetis D, Ioannou CV. Embolization or Simple Coverage to Exclude the Internal Iliac Artery During Endovascular Repair of Aortoiliac Aneurysms? Systematic Review and Meta-analysis of Comparative Studies. J Endovasc Ther 2016; 24:47-56. [DOI: 10.1177/1526602816677962] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: To compare results of simple coverage vs preemptive embolization to exclude the internal iliac artery (IIA) during endovascular repair of aortoiliac aneurysms. Methods: A systematic review of the literature was conducted by searching MEDLINE, CENTRAL, and OpenGray databases until March 2016. Primary outcome measures were safety and efficacy of the 2 strategies. Safety was determined by 30-day mortality and the minor and major complication rates. Efficacy was determined by absence of endoleak from the target IIA. Secondary outcomes of any endoleak, reintervention, operative time, fluoroscopy time, blood loss, contrast volume, and length of hospitalization were also examined. The random effects model was used to calculate combined overall effect sizes of pooled data. Data are presented as the odds ratio (OR) or mean difference (MD) with 95% confidence interval (CI). Forest plots and inconsistency ( I2) statistics were used to evaluate the heterogeneity of the included studies. Results: Eight observational studies were included in the analysis. Overall, 284 and 255 subjects underwent IIA coverage or embolization, respectively. IIA coverage resulted in a significantly lower major complication rate (6% vs 29%; OR 2.97, 95% CI 1.46 to 6.04, p=0.003; I2=0%) and shorter hospitalization (MD 0.48 days, 95% CI 0.08 to 0.89, p=0.02; I2=0%), while differences in all other outcomes were not statistically significant. Conclusion: In the presence of limited data, available evidence suggests that simple coverage of the IIA may result in significantly fewer major complications compared to preemptive embolization; at the same time, the rates of endoleaks and/or reinterventions are similar between groups.
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Affiliation(s)
- Nikolaos Kontopodis
- Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University Hospital of Heraklion, University of Crete Medical School, Heraklion, Greece
| | - Emmanouil Tavlas
- Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University Hospital of Heraklion, University of Crete Medical School, Heraklion, Greece
| | - George Papadopoulos
- Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University Hospital of Heraklion, University of Crete Medical School, Heraklion, Greece
| | - Nikolaos Galanakis
- Interventional Radiology Unit, University Hospital of Heraklion, University of Crete Medical School, Heraklion, Greece
| | - Dimitrios Tsetis
- Interventional Radiology Unit, University Hospital of Heraklion, University of Crete Medical School, Heraklion, Greece
| | - Christos V. Ioannou
- Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University Hospital of Heraklion, University of Crete Medical School, Heraklion, Greece
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McGarry JG, Alenezi AO, McGrath FP, Given MF, Keeling AN, Moneley DS, Leahy AL, Lee MJ. How safe is internal iliac artery embolisation prior to EVAR? A 10-year retrospective review. Ir J Med Sci 2015; 185:865-869. [PMID: 26597950 DOI: 10.1007/s11845-015-1384-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 11/16/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Internal iliac artery (IIA) embolisation is commonly performed prior to endovascular aneurysm repair (EVAR) of aortoiliac aneurysms to prevent type 2 endoleaks via the internal iliac arteries. The safety of this procedure is controversial due to the high incidence of pelvic ischaemic complications. METHODS We undertook a retrospective review of all patients undergoing IIA embolisation before EVAR from 2002 to 2012, to determine incidence of, and factors associated with pelvic ischaemia. RESULTS Eight of 25 patients (32 %) experienced new-onset ischaemia, including erectile dysfunction (4 %), and buttock claudication (28 %) that persisted >6 months in only four patients (16 %). Both bilateral IIA embolisation and a shorter time interval to EVAR correlate with increased risk (p = 0.006 and p = 0.044). No co-morbidities or demographic factors were predictive. CONCLUSIONS We conclude that IIA embolisation remains a beneficial procedure, however, to minimise the risk of buttock claudication we advise against both bilateral IIA embolisation and short time intervals between embolisation and subsequent EVAR.
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Affiliation(s)
- J G McGarry
- Department of Academic Radiology, Beaumont Hospital Dublin, Dublin, Ireland.
| | - A O Alenezi
- Department of Academic Radiology, Beaumont Hospital Dublin, Dublin, Ireland
| | - F P McGrath
- Department of Academic Radiology, Beaumont Hospital Dublin, Dublin, Ireland
| | - M F Given
- Department of Academic Radiology, Beaumont Hospital Dublin, Dublin, Ireland
| | - A N Keeling
- Department of Academic Radiology, Beaumont Hospital Dublin, Dublin, Ireland
| | - D S Moneley
- Department of Surgery, Beaumont Hospital Dublin, Dublin, Ireland
| | - A L Leahy
- Department of Surgery, Beaumont Hospital Dublin, Dublin, Ireland.,Faculty of Radiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - M J Lee
- Department of Academic Radiology, Beaumont Hospital Dublin, Dublin, Ireland.,Faculty of Radiology, Royal College of Surgeons in Ireland, Dublin, Ireland
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Endovascular Hypogastric Artery Preservation During Endovascular Aneurysm Repair: A Review of Current Techniques and Devices. Ann Vasc Surg 2015; 29:367-76. [DOI: 10.1016/j.avsg.2014.10.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 10/21/2014] [Accepted: 10/25/2014] [Indexed: 11/23/2022]
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8
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Kalteis M, Gangl O, Huber F, Adelsgruber P, Kastner M, Lugmayr H. Clinical impact of hypogastric artery occlusion in endovascular aneurysm repair. Vascular 2014; 23:575-9. [DOI: 10.1177/1708538114560462] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose To report the long-term results for patients treated with endovascular aneurysm repair and additional embolization and coverage of the hypogastric artery compared with patients treated with simple endovascular aneurysm repair. Methods A database of our endovascular aneurysm repair patient cohort was reviewed to find patients with iliac artery aneurysms. The baseline characteristics, the procedural data and the results for patients treated with endovascular aneurysm repair and concomitant hypogastric artery embolization were compared with those for patients treated with simple endovascular aneurysm repair. The results were analyzed for significant differences. Results Of 106 endovascular aneurysm repair patients treated at our vascular unit from 2001 to 2010, 24 had undergone additional hypogastric artery embolization. The complication rate was significantly increased in this group (12.5% vs. 2.4%; p = 0.041), and the long-term results were significantly poorer. Additional hypogastric artery embolization resulted in late rupture (1.2% vs. 12.5%; p = 0.036), buttock claudication (8.6% vs. 43.8%; p = 0.001) and new onset erectile dysfunction (17.3% vs. 42.9%; p = 0.043). Conclusion Endovascular aneurysm repair with extension of the stent graft to the external iliac artery and embolization of the hypogastric artery was associated with more complications and worse long-term results compared with simple endovascular aneurysm repair.
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Affiliation(s)
- Manfred Kalteis
- Department of cardiovascular Surgery, Klinikum Wels-Grieskirchen, Wels, Austria
- Department of Surgery, Elisabethinen Hospital, Linz, Austria
| | - Odo Gangl
- Department of Surgery, Elisabethinen Hospital, Linz, Austria
| | - Florian Huber
- Department of cardiovascular Surgery, Klinikum Wels-Grieskirchen, Wels, Austria
| | | | - Manfred Kastner
- Department of Interventional Radiology, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Herbert Lugmayr
- Department of Interventional Radiology, Klinikum Wels-Grieskirchen, Wels, Austria
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Rajesparan K, Partridge W, Refson J, Abidia A, Aldin Z. The risk of endoleak following stent covering of the internal iliac artery during endovascular aneurysm repair. Clin Radiol 2014; 69:1011-8. [PMID: 24957857 DOI: 10.1016/j.crad.2014.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 04/09/2014] [Accepted: 05/15/2014] [Indexed: 11/29/2022]
Abstract
AIM To investigate the risk of endoleak during endovascular aneurysm repair (EVAR) involving the distal common iliac artery (CIA) when the internal iliac artery (IIA) is covered without prior coil embolization. MATERIALS AND METHODS Retrospective analysis of 145 (125 men, 20 women) consecutive EVAR cases. Clinical notes and radiological images were reviewed, and data collected on patient demographics, aneurysm morphology, covering of the IIA with or without embolization, presence of endoleaks, and patient symptoms relating to IIA ischaemia. RESULTS A total of 29 IIAs (10%) were covered in a total of 25 patients. Seven IIAs (24%) were embolized before stent covering (Embolization group), and 22 IIAs (76%) were covered only without embolization (Cover group). There was no statistically significant difference in the mean size of the abdominal aortic aneurysm diameter or CIA diameter between each group. No endoleaks from IIA retrograde filling were found in either group. CONCLUSION The results of the present study do not support the traditional view that coverage of the IIA without prior embolization carries a high risk of endoleak, with no endoleaks seen in all 22 cases. Large-scale trials are required. However, the advent of branched-stenting techniques and the emergence of their success in long-term follow-up may preclude the former.
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Affiliation(s)
- K Rajesparan
- Department of Radiology, The Princess Alexandra Hospital, Hamstel Road, Harlow, Essex, CM20 1QX, UK.
| | - W Partridge
- Department of Radiology, The Princess Alexandra Hospital, Hamstel Road, Harlow, Essex, CM20 1QX, UK
| | - J Refson
- Department of Surgery, The Princess Alexandra Hospital, Hamstel Road, Harlow, Essex, CM20 1QX, UK
| | - A Abidia
- Department of Surgery, The Princess Alexandra Hospital, Hamstel Road, Harlow, Essex, CM20 1QX, UK
| | - Z Aldin
- Department of Radiology, The Princess Alexandra Hospital, Hamstel Road, Harlow, Essex, CM20 1QX, UK
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In endovascular aneurysm repair cases, when should you consider internal iliac artery embolization when extending a stent into the external iliac artery?: Table 1:. Interact Cardiovasc Thorac Surg 2014; 18:821-4. [DOI: 10.1093/icvts/ivu042] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chun JY, Mailli L, Abbasi MA, Belli AM, Gonsalves M, Munneke G, Ratnam L, Loftus IM, Morgan R. Embolization of the internal iliac artery before EVAR: is it effective? Is it safe? Which technique should be used? Cardiovasc Intervent Radiol 2013; 37:329-36. [PMID: 23771327 DOI: 10.1007/s00270-013-0659-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 05/11/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the clinical outcomes of internal iliac artery (IIA) embolization before endovascular aneurysm repair (EVAR). METHODS Between 2002 and 2011, 88 patients underwent IIA embolization prior to EVAR. Sixty-five patients underwent unilateral and 23 underwent bilateral IIA embolization. A total of 111 IIAs were embolized: 56 were embolized with coils, 41 with Amplatzer plugs, and 14 with a combination of embolic agents. The outcomes were assessed retrospectively by reviewing medical records and follow-up imaging. RESULTS IIA embolization was technically successful in 95.7% of cases. Type 2 endoleak from previously embolized IIAs was seen in 4 cases, and in 1 case this was significant necessitating re-intervention. Buttock claudication was reported in 38% of cases, whereas new onset erectile dysfunction occurred in 10% of cases. No severe ischemic complications, such as spinal cord ischaemia or buttock necrosis, were reported. Analysis comparing unilateral versus bilateral embolization, simultaneous versus sequential embolization, and the type of embolic material used showed no statistical significance. CONCLUSION IIA embolization is technically successful and effective in preventing significant type 2 endoleak in the majority of cases. It is a relatively safe procedure without major complications, but the incidence of buttock claudication and erectile dysfunction remain relatively high, and patients should be consented appropriately. There is no significant benefit for adopting a particular embolization technique, but there is a tendency towards reduced pelvic ischaemia with proximal embolization. Four cases of type II endoleak occurring after technically successful IIA embolization supports the school of thought that IIA should be embolized prior to coverage and extension of the distal landing zone.
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Affiliation(s)
- Joo-Young Chun
- Department of Radiology, St. George's Hospital, London, SW17 0QT, UK,
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Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms With the Endurant Device. Ann Vasc Surg 2013; 27:162-7. [DOI: 10.1016/j.avsg.2012.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 03/14/2012] [Accepted: 04/11/2012] [Indexed: 12/20/2022]
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Stokmans RA, Willigendael EM, Teijink JAW, Ten Bosch JA, van Sambeek MRHM, Cuypers PWM. Challenging the evidence for pre-emptive coil embolisation of the internal iliac artery during endovascular aneurysm repair. Eur J Vasc Endovasc Surg 2013; 45:220-6. [PMID: 23305786 DOI: 10.1016/j.ejvs.2012.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 12/06/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES We retrospectively analysed the results of a strategy in which coverage of the internal iliac artery (IIA) during endovascular aneurysm repair (EVAR) was routinely performed without coil embolisation. METHODS From January 2010 until May 2012, 32 patients (96.9% men; mean age 73.0 years, range 52-89 years) underwent EVAR with stent grafts extended into the external iliac artery (EIA), all without prior coil embolisation. Aneurysm morphology was determined on preoperative computed tomography (CT) images. During follow-up, patients were interviewed about buttock claudication, and the occurrence of endoleaks and evolution of aneurysm diameter were recorded. RESULTS At baseline, the mid-common iliac artery (CIA) diameter was 33.5 ± 16.8 mm and seven patients presented with ruptured aneurysms. Mean follow-up was 14.3 ± 7.4 months. There were eight deaths, none related to IIA coverage. Buttock claudication occurred in seven (22.6%) patients, which persisted after 6 months in two cases of bilateral IIA coverage. No Type-I or -II endoleaks occurred related to IIA coverage. Aneurysm growth was not observed. CONCLUSION Endovascular treatment of aortoiliac and iliac aneurysm without pre-emptive coil embolisation of the IIA appears safe and effective. No IIA-related endoleaks or re-interventions occurred in our series. This approach saves operating time, contrast load and costs and may reduce complications. However, a larger population and longer follow-up is required to confirm our findings.
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Affiliation(s)
- R A Stokmans
- Department of Vascular Surgery, Catharina Hospital, Michelangelolaan 2, PO Box 1350, 5602 ZA Eindhoven, The Netherlands
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Abderhalden S, Rancic Z, Lachat ML, Pfammatter T. Retrograde hypogastric artery embolization to treat iliac artery aneurysms growing after aortoiliac repair. J Vasc Interv Radiol 2012; 23:873-7. [PMID: 22720892 DOI: 10.1016/j.jvir.2012.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Revised: 03/29/2012] [Accepted: 04/05/2012] [Indexed: 11/25/2022] Open
Abstract
Transarterial embolization of the feeding internal iliac artery branches via the hypogastric-femoral collateral pathway was feasible in four patients with expanding iliac artery aneurysms and occluded internal iliac artery origins after aortoiliac repair.
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Affiliation(s)
- Susanne Abderhalden
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
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15
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Comparison of outcomes with coils versus vascular plug embolization of the internal iliac artery for endovascular aortoiliac aneurysm repair. J Vasc Surg 2012; 56:1239-45. [DOI: 10.1016/j.jvs.2012.05.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 04/24/2012] [Accepted: 05/02/2012] [Indexed: 11/20/2022]
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16
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Outcomes of endovascular aneurysm repair with selective internal iliac artery coverage without coil embolization. J Vasc Surg 2012; 56:298-303. [DOI: 10.1016/j.jvs.2011.08.063] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 08/03/2011] [Accepted: 08/11/2011] [Indexed: 11/15/2022]
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Zastrow C, Motaganahalli RL, Matsumura JS. Femoral-femoral stabilizing buddy wire for embolization of the internal iliac artery. J Vasc Surg 2012; 55:1526-8. [PMID: 22209616 DOI: 10.1016/j.jvs.2011.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2011] [Revised: 10/03/2011] [Accepted: 11/01/2011] [Indexed: 10/14/2022]
Abstract
Internal iliac artery (IIA) embolization is performed in a variety of clinical scenarios, most commonly in patients undergoing endovascular aneurysm repair (EVAR) with an iliac artery aneurysm or inadequate distal landing zone. In these patients, IIA embolization with iliac limb extension is often performed. While IIA embolization can be routinely performed with either ipsilateral or contralateral femoral arterial access, it can be challenging in some patients with an acutely angulated aortic or iliac bifurcation and in patients with short or ectatic common iliac arteries. In this select group of patients with difficult anatomy, IIA embolization can be challenging and may lead to increased radiation exposure and contrast administration. Having a sheath precisely positioned and stabilized at the internal iliac artery origin will facilitate embolization of the IIA. This report describes a novel technique in which crossover femoral-femoral artery buddy wire placement achieves stable positioning of large sheaths for concurrent IIA embolization at the time of EVAR.
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Melas N, Saratzis A, Dixon H, Saratzis N, Lazaridis J, Perdikides T, Kiskinis D. Isolated Common Iliac Artery Aneurysms:A Revised Classification to Assist Endovascular Repair. J Endovasc Ther 2011; 18:697-715. [PMID: 21992642 DOI: 10.1583/11-3519.1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Kirkwood ML, Saunders A, Jackson BM, Wang GJ, Fairman RM, Woo EY. Aneurysmal iliac arteries do not portend future iliac aneurysmal enlargement after endovascular aneurysm repair for abdominal aortic aneurysm. J Vasc Surg 2011; 53:269-73. [DOI: 10.1016/j.jvs.2010.08.062] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 08/18/2010] [Accepted: 08/23/2010] [Indexed: 10/18/2022]
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Maleux G, Willems E, Vaninbroukx J, Nevelsteen A, Heye S. Outcome of Proximal Internal Iliac Artery Coil Embolization prior to Stent-graft Extension in Patients Previously Treated by Endovascular Aortic Repair. J Vasc Interv Radiol 2010; 21:990-4. [DOI: 10.1016/j.jvir.2010.02.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Revised: 02/19/2010] [Accepted: 02/25/2010] [Indexed: 10/19/2022] Open
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Karthikesalingam A, Hinchliffe RJ, Malkawi AH, Holt PJ, Loftus IM, Thompson MM. Morphological Suitability of Patients With Aortoiliac Aneurysms for Endovascular Preservation of the Internal Iliac Artery Using Commercially Available Iliac Branch Graft Devices. J Endovasc Ther 2010; 17:163-71. [DOI: 10.1583/09-2942.1] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Endovascular Abdominal Aortic Aneurysm Repair: Part I. Ann Vasc Surg 2009; 23:799-812. [DOI: 10.1016/j.avsg.2009.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 03/21/2009] [Indexed: 12/20/2022]
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23
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Wibmer A, Meyer B, Albrecht T, Buhr HJ, Kruschewski M. Improving Results of Elective Abdominal Aortic Aneurysm Repair at a Low-Volume Hospital by Risk-Adjusted Selection of Treatment in the Endovascular Era. Cardiovasc Intervent Radiol 2009; 32:918-22. [DOI: 10.1007/s00270-009-9538-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2008] [Revised: 01/19/2009] [Accepted: 02/04/2009] [Indexed: 11/28/2022]
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24
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Contemporary Management of Aorto-iliac Aneurysms in the Endovascular Era. Eur J Vasc Endovasc Surg 2009; 37:182-8. [DOI: 10.1016/j.ejvs.2008.11.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Accepted: 11/03/2008] [Indexed: 11/19/2022]
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