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Torrealba JI, Grandi A, Nana P, Panuccio G, Rohlffs F, Kölbel T. Dilated Internal Iliac Artery Confers a Higher Risk of Endoleak in Iliac Branch Devices in a Single Centre Retrospective Experience. Eur J Vasc Endovasc Surg 2024; 67:895-902. [PMID: 38320646 DOI: 10.1016/j.ejvs.2024.01.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/18/2024] [Accepted: 01/30/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE Iliac branch devices (IBDs) have shown good results but there is little evidence for the risk of internal iliac artery (IIA) endoleak, so there are no clear recommendations on the maximum diameter it should be. Based on limited evidence, it was hypothesised that an IIA of ≥ 11 mm in diameter presents an increased risk of type Ic endoleak. METHODS This was a single centre, retrospective case control study. Patients undergoing an IBD with the main trunk of the IIA as the target vessel, between 2015 and 2021, were identified. Two groups were created: those with a main trunk diameter of < 11 mm; and those with a diameter of ≥ 11 mm. Technical success, freedom from type Ic endoleak, and re-intervention rates were compared. A receiver operating characteristic (ROC) curve was performed to show a cutoff IIA diameter value for risk of type Ic endoleak. Multivariate analysis was performed to assess the risk of type Ic endoleak and the presence of calcification, stenosis, and landing zone length in the IIA. RESULTS There were 182 IBDs identified. The dilated IIA group (54 IBDs) had significantly lower technical success (91% vs. 98.4%; p = .002), lower freedom from type Ic endoleak (77% vs. 97.1% at 24 months; p = .001), and lower freedom from re-interventions (70% vs. 92.4% at 24 months; p = .002). The ROC curve showed that 10.5 mm was the cutoff diameter for type Ic endoleak. Moderate or severe calcification as well as landing zone length < 5 mm also correlated with type Ic endoleak. CONCLUSION IBDs have a statistically significantly higher rate of technical failure, lower freedom from type Ic endoleak, and lower freedom from re-intervention when the IIA is ≥ 11 mm in diameter.
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Affiliation(s)
- Jose I Torrealba
- German Aortic Centre Hamburg, Department of Vascular Medicine, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
| | - Alessandro Grandi
- German Aortic Centre Hamburg, Department of Vascular Medicine, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Petroula Nana
- German Aortic Centre Hamburg, Department of Vascular Medicine, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Giuseppe Panuccio
- German Aortic Centre Hamburg, Department of Vascular Medicine, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Fiona Rohlffs
- German Aortic Centre Hamburg, Department of Vascular Medicine, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Tilo Kölbel
- German Aortic Centre Hamburg, Department of Vascular Medicine, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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Franklin RN, Timi JRR, Baumgardt G, Bortoluzzi C, Galego G, Oderich GS, Silveira PG. Laboratory "In-vitro" Evaluation of the Parallel Stent Graft Association for the Iliac Sandwich Technique. Cardiovasc Intervent Radiol 2022; 45:1377-1384. [PMID: 35778578 DOI: 10.1007/s00270-022-03182-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 05/11/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVES The Iliac Sandwich is an off-label technique that uses parallel stent grafts to treat aortoiliac aneurysms. The purpose of this experimental study is to evaluate the conformability and juxtaposition of stent grafts combinations used in this technique through in-vitro mechanical evaluation, computed tomography (CT) analyses, and a controlled pulsatile flow system. METHODS The combinations of two Viabahn® ("V-V") or Viabahn® and Excluder® iliac extension ("V-E") were analysed using CT imaging with measurement of the gutter area by two independent analysts before and after balloon angioplasty. In a second phase, the parallel stent combinations were also evaluated using CT imaging after being implanted in the aortic aneurysm model with a pulsatile flow system with controlled temperature, viscosity, and density. RESULTS The "V-E" group had a better conformability when compared to the "V-V" group, ensuring smaller gutter areas (0.0064 cm2 ± 0.01 vs. 0.0228 cm2 ± 0.03, p < 0.001). Post dilatation with two non-compliant balloons resulted in enlargement of the gutter area (Area A, p 0.065; Area B, p 0.071). Conversely, post dilatation with a non-compliant balloon for the internal iliac component and a compliant balloon for the external iliac device reduced the gutter area (Area A, p 0.008; Area B, p 0.010). CONCLUSION The combination of Viabahn® and Excluder® iliac extension device ("V-E") had a smaller gutter area compared to two Viabahn® parallel stents for the Iliac Sandwich Technique. Post dilatation using a non-compliant balloon for the internal iliac device and a compliant balloon for the external iliac provided superior conformability and juxtaposition.
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Affiliation(s)
- Rafael Narciso Franklin
- Coris Cirurgia Vascular e Endovascular, Rua Menino Deus, 63 sala 504, Baia Sul Medical Center, Centro, Florianópolis, SC, 88020-210, Brazil. .,Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
| | | | | | - Cristiano Bortoluzzi
- Coris Cirurgia Vascular e Endovascular, Rua Menino Deus, 63 sala 504, Baia Sul Medical Center, Centro, Florianópolis, SC, 88020-210, Brazil
| | - Gilberto Galego
- Coris Cirurgia Vascular e Endovascular, Rua Menino Deus, 63 sala 504, Baia Sul Medical Center, Centro, Florianópolis, SC, 88020-210, Brazil.,Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Gustavo S Oderich
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Pierre Galvagni Silveira
- Coris Cirurgia Vascular e Endovascular, Rua Menino Deus, 63 sala 504, Baia Sul Medical Center, Centro, Florianópolis, SC, 88020-210, Brazil.,Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
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3
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A systematic review and meta-analysis of the clinical effectiveness and safety of unilateral versus bilateral iliac branch devices for aortoiliac and iliac artery aneurysms. J Vasc Surg 2022; 76:1089-1098.e8. [PMID: 35314303 DOI: 10.1016/j.jvs.2022.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/04/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Iliac branch devices (IBDs) have been utilized in the treatment of aortoiliac and isolated iliac artery aneurysms. The aims of this systematic review and meta-analysis were to investigate the clinical effectiveness and safety of IBDs. METHODS A systematic review of the literature was conducted by identifying studies in the Medline, EMBASE, and Cochrane databases regarding the outcomes of IBDs in aortoiliac or isolated iliac artery aneurysms between May 2006 and December 2020. Individual studies were evaluated for the following major outcomes: technical success, 30-day mortality, primary patency, endoleak, reintervention, and rates of pelvic ischemia. Furthermore, sub-group meta-analyses were performed to compare the pelvic ischemic events in patients with bilateral IBDs, unilateral IBDs and bilateral internal iliac artery (IIA) embolization/coverage. RESULTS 45 studies with a total of 2736 patients undergoing unilateral or bilateral IBDs met inclusion criteria and were included in the analysis. The pooled technical success rate of IBD was 98.0% (CI: 97.3-98.7%). Following IBD treatment, the 30-day mortality rate was 0.4% (CI: 0.07-0.70%); 30-day patency was 98.4% (CI: 97.7-99.0%); buttock claudication developed in 1.84% (CI: 1.26-2.41%); endoleak occurred in 11.9% (CI: 9.2-14.7%) and re-intervention in 7.6% (CI: 5.65-9.58%). Furthermore, in the patients with bilateral iliac artery involvement the pooled estimate rates of buttock claudication were 0.7% in bilateral IBD group, 7.9% in unilateral IBD with contralateral IIA embolization patients and 33.8% in bilateral IIA embolization/coverage patients, which were statistically significant among the three groups. Sexual dysfunction was 5.0% in bilateral IIA occlusion group, which was significantly higher than that in IBD groups. CONCLUSIONS The utilization of IBDs in treatment of aortoiliac or isolated iliac artery aneurysms is associated with high technical success rates as well as low incidences of pelvic ischemia. The risk of postoperative buttock claudication can be further decreased with both IIA preservation if patients are anatomically suitable for bilateral IBDs.
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Late outcomes of different hypogastric stent grafts in aortoiliac endografting with iliac branch device: Results from the pELVIS Registry. J Vasc Surg 2020; 72:549-555.e1. [DOI: 10.1016/j.jvs.2019.09.065] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/27/2019] [Indexed: 11/20/2022]
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Giosdekos A, Antonopoulos CN, Sfyroeras GS, Moulakakis KG, Tsilimparis N, Kakisis JD, Lazaris A, Chatziioannou A, Geroulakos G. The use of iliac branch devices for preservation of flow in internal iliac artery during endovascular aortic aneurysm repair. J Vasc Surg 2020; 71:2133-2144. [DOI: 10.1016/j.jvs.2019.10.087] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 10/19/2019] [Indexed: 01/24/2023]
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6
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A propensity score-matched comparison of two commercially available iliac branch devices in patients with similar clinical and anatomic preoperative features. J Vasc Surg 2020; 71:1207-1214. [DOI: 10.1016/j.jvs.2019.07.058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/12/2019] [Indexed: 11/24/2022]
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Iliac Aneurysms Treated with Endovascular Iliac Branch Device: A Systematic Review and Meta-analysis. Ann Vasc Surg 2019; 56:303-316. [DOI: 10.1016/j.avsg.2018.07.058] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 07/16/2018] [Accepted: 07/19/2018] [Indexed: 11/22/2022]
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8
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Brunkwall J, Vaquero Puerta C, Heckenkamp J, Egaña Barrenechea JM, Szopinski P, Mertikian G, Seifert S, Rümenapf G, Buz S, Assadian A, Majd P, Mylonas S, Revilla Calavia A, Theis T, de Blas Bravo M, Pleban E, Schupp J, Esche M, Kocaer C, Hirsch K, Oberhuber A, Schäfer JP. Prospective study of the E-liac Stent Graft System in patients with common iliac artery aneurysms: 30-Day results. Vascular 2018; 26:647-656. [PMID: 30037302 DOI: 10.1177/1708538118789510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To study the safety and feasibility of the E-liac Stent Graft System® in patients with aorto/iliac aneurysms. METHODS A prospective multicentric European registry of patients receiving the E-liac Stent Graft System® was conducted. Endpoints of the study included the technical success as well as periprocedural events and 30-day endoleaks, reinterventions, internal and external iliac artery patency and mortality. RESULTS Between July 2014 and June 2016, a total of 45 patients (93% men, mean age 72 years, range 53-90 years) were enrolled at 11 sites in four European countries. Five patients received an isolated iliac treatment. Thirty-seven patients were treated with a combination of an abdominal stent graft and a unilateral E-liac and three in combination with bilateral E-liac. All E-liac Stent Grafts (48) were implanted in the intended position and the internal iliac arteries were successfully bridged. Two patients did not receive clinical success, due to endoleak type Ia of the aortic stent graft. At 30-day follow-up, clinical success rate was 96%. Three successful endovascular reinterventions were performed within the 30-day follow-up: one due to a type Ia endoleak in the common iliac artery, one due to type Ia endoleak of the aortic stent graft, and one due to bilateral lower limb claudication provoked by stent graft limb stenosis. At 30-day, a 100% survival rate and complete absence of pelvic or buttock ischemia/claudication were reported. Primary patency at 30 days was 100% for the internal iliac artery and 98% for the external iliac artery with an assisted patency of 100% in the latter. CONCLUSIONS The high clinical success rate, low rates of device-related reinterventions (2%), and excellent patency rate demonstrate the safety and feasibility of the E-liac Stent Graft System. Long-term results are awaited to state efficacy and durability. Clinical Trials.gov. Identifier no. NCT02209194.
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Affiliation(s)
- Jan Brunkwall
- 1 Clinic of Vascular and Endovascular Surgery, University Clinic of Cologne, Cologne, Germany
| | | | - Joerg Heckenkamp
- 3 Department of Vascular and Endovascular Surgery, Marienhospital, Osnabrück, Germany
| | | | - Piotr Szopinski
- 5 Clinic of Vascular Surgery, Institute of Haematology and Transfusion Medicine, Warsaw, Poland
| | - Gerard Mertikian
- 6 Department of Interventional Radiology, Hietzing Hospital, Vienna, Austria
| | - Sven Seifert
- 7 Klinik für Thorax-, Gefäß- und endovaskuläre Chirurgie, Klinikum Chemnitz gGmbH, Germany
| | - Gerhard Rümenapf
- 8 Department of Vascular Surgery, Diakonissen Speyer-Mannheim Hospital, Speyer, Germany
| | - Semih Buz
- 9 Deutsches Herzzentrum Berlin, Berlin, Germany
| | | | - Payman Majd
- 1 Clinic of Vascular and Endovascular Surgery, University Clinic of Cologne, Cologne, Germany
| | - Spyridon Mylonas
- 1 Clinic of Vascular and Endovascular Surgery, University Clinic of Cologne, Cologne, Germany
| | | | - Thorsten Theis
- 3 Department of Vascular and Endovascular Surgery, Marienhospital, Osnabrück, Germany
| | - Mariano de Blas Bravo
- 4 Department of Vascular Surgery, Donostia University Hospital, San Sebastián, Spain
| | - Eliza Pleban
- 5 Clinic of Vascular Surgery, Institute of Haematology and Transfusion Medicine, Warsaw, Poland
| | - Jasper Schupp
- 11 Department of Radiology, University of Kiel, Kiel, Germany
| | - Mirko Esche
- 7 Klinik für Thorax-, Gefäß- und endovaskuläre Chirurgie, Klinikum Chemnitz gGmbH, Germany
| | - Cetin Kocaer
- 8 Department of Vascular Surgery, Diakonissen Speyer-Mannheim Hospital, Speyer, Germany
| | | | - Alexander Oberhuber
- 12 Department of Vascular and Endovascular Surgery, University of Düsseldorf, Germany
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Jmal H, Ben Jmaà H, Masmoudi S, Cherif T, Cheikhrouhou H, Maalej A, Elleuch N, Jemel A, Frikha I. [Management of isolated iliac aneurysms: A Tunisian center experience]. JOURNAL DE MÉDECINE VASCULAIRE 2017; 42:349-357. [PMID: 29203041 DOI: 10.1016/j.jdmv.2017.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 06/27/2017] [Indexed: 11/17/2022]
Abstract
Isolated aneurysms of the iliac arteries are rare. The diagnoses of these aneurysms become easier with non-invasive radiologic investigations. The development of endovascular treatment is a recent alternative to surgical treatment. We report our experience in the management of 8 cases of isolated iliac aneurysms in the department of cardiovascular and thoracic surgery of the Habib Bourguiba Hospital of Sfax.
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Affiliation(s)
- H Jmal
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib-Bourguiba, avenue Mmajida-Boulila, 3029 Sfax, Tunisie
| | - H Ben Jmaà
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib-Bourguiba, avenue Mmajida-Boulila, 3029 Sfax, Tunisie.
| | - S Masmoudi
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib-Bourguiba, avenue Mmajida-Boulila, 3029 Sfax, Tunisie
| | - T Cherif
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib-Bourguiba, avenue Mmajida-Boulila, 3029 Sfax, Tunisie
| | - H Cheikhrouhou
- Service d'anesthésie-réanimation, hôpital Habib-Bourguiba, 3029 Sfax, Tunisie
| | - A Maalej
- Service de radiologie, hôpital Habib-Bourguiba, 3029 Sfax, Tunisie
| | - N Elleuch
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib-Bourguiba, avenue Mmajida-Boulila, 3029 Sfax, Tunisie
| | - A Jemel
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib-Bourguiba, avenue Mmajida-Boulila, 3029 Sfax, Tunisie
| | - I Frikha
- Service de chirurgie cardiovasculaire et thoracique, hôpital Habib-Bourguiba, avenue Mmajida-Boulila, 3029 Sfax, Tunisie
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Simonte G, Parlani G, Farchioni L, Isernia G, Cieri E, Lenti M, Cao P, Verzini F. Lesson Learned with the Use of Iliac Branch Devices: Single Centre 10 Year Experience in 157 Consecutive Procedures. Eur J Vasc Endovasc Surg 2017; 54:95-103. [DOI: 10.1016/j.ejvs.2017.03.026] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 03/31/2017] [Indexed: 01/29/2023]
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Delay C, Deglise S, Lejay A, Georg Y, Roussin M, Schaeffer M, Saucy F, Thaveau F, Corpataux JM, Chakfe N. Zenith Bifurcated Iliac Side Branch Device: Mid-term Results and Assessment of Risk Factors for Intraoperative Thrombosis. Ann Vasc Surg 2017; 41:141-150. [PMID: 28238918 DOI: 10.1016/j.avsg.2016.08.048] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/03/2016] [Accepted: 08/23/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study is to evaluate the short- and mid-term results of the Zenith bifurcated iliac side branch device (ZBIS) in the treatment of common iliac artery (CIA) aneurysms, and to assess risk factors for intraoperative internal iliac artery (IIA) thrombosis. METHODS All patients who underwent endovascular treatment of either an isolated CIA aneurysm or an aortoiliac aneurysm using the ZBIS device in the departments of vascular surgery of Strasbourg (France) and Lausanne (Switzerland) between January 2010 and December 2014 were retrospectively collected. RESULTS Thirty-one implantations were performed: 30 patients underwent 31 endovascular CIA aneurysm treatments with the ZBIS device. Mean operative time was 188 min. Technical success was obtained in 26 implantations (84%). In 5 implantations (16%), the final angiogram revealed an IIA thrombosis. Thirty-day mortality was 3.2%. Thirty-day morbidity was 13.3%. Mean follow-up was 15 months. Overall survival was 96% at 1 year and 89% at 2 years. In intention-to-treat analysis, primary patency of the internal iliac side branch was 84% at 1 year and 76% at 2 years (5 peroperative IIA occlusions and 1 late occlusion). Freedom from reintervention was 89% at 1 and 2 years. One case of type III endoleak and 2 cases of type II endoleaks were identified. Only type III endoleak required an additional intervention with a covered stent. Aneurysm diameter decreased in 15 implantations (48%) and remained stable in 16 implantations (52%). Clinical, radiological, and peroperative parameters were analyzed to identify risk factor for intraoperative thrombosis of the internal iliac side branch. Notion of intraoperative difficulties (any additional procedure that was not initially planned and increasing the operating time) appeared as a risk factor in multivariate analysis (P < 0.01, standard deviation 1.27, odds ratio 30.6). CONCLUSIONS The main findings of our study is that the procedure can be difficult to perform in particular conditions and can lead to peroperative failure in these cases, highlighting the need for adequate patients screening. When technical success is obtained, outcomes can be considered as satisfactory.
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Affiliation(s)
- Charline Delay
- Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France
| | - Sébastien Deglise
- Department of Vascular Surgery, University Hospital of Lausanne, Lausanne, Switzerland
| | - Anne Lejay
- Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France
| | - Yannick Georg
- Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France
| | - Mathieu Roussin
- Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France
| | - Mickaël Schaeffer
- Department of Methodology and Biostatistics, University Hospital of Strasbourg, Strasbourg, France
| | - François Saucy
- Department of Vascular Surgery, University Hospital of Lausanne, Lausanne, Switzerland
| | - Fabien Thaveau
- Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France
| | - Jean-Marc Corpataux
- Department of Vascular Surgery, University Hospital of Lausanne, Lausanne, Switzerland
| | - Nabil Chakfe
- Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France.
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Jongsma H, Bekken JA, Bekkers WJJ, Zeebregts CJ, van Herwaarden J, Hoksbergen A, Cuypers P, de Vries JPPM, Verhagen HJ, Fioole B. Endovascular Treatment of Common Iliac Artery Aneurysms With an Iliac Branch Device. J Endovasc Ther 2016; 24:239-245. [DOI: 10.1177/1526602816679132] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: 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. Methods: 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). Results: 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. Conclusion: 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.
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Affiliation(s)
- Hidde Jongsma
- Department of Vascular Surgery, Maasstad Hospital, Rotterdam, the Netherlands
| | - Joost A. Bekken
- Department of Vascular Surgery, Maasstad Hospital, Rotterdam, the Netherlands
| | | | - Clark J. Zeebregts
- Department of Vascular Surgery, University Medical Center, Groningen, the Netherlands
| | - Joost van Herwaarden
- Department of Vascular Surgery, University Medical Center, Utrecht, the Netherlands
| | - Arjan Hoksbergen
- Department of Vascular Surgery, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
| | - Philip Cuypers
- Department of Vascular Surgery, Catharina Hospital, Eindhoven, the Netherlands
| | | | - Hence J. Verhagen
- Department of Vascular Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bram Fioole
- Department of Vascular Surgery, Maasstad Hospital, Rotterdam, the Netherlands
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Conformability of GORE Excluder Iliac Branch Endoprosthesis and COOK Zenith Bifurcated Iliac Side Branched Iliac Stent Grafts. Ann Vasc Surg 2016; 36:139-144. [DOI: 10.1016/j.avsg.2016.02.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 02/19/2016] [Accepted: 02/23/2016] [Indexed: 11/18/2022]
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14
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Gray D, Shahverdyan R, Jakobs C, Brunkwall J, Gawenda M. Endovascular Aneurysm Repair of Aortoiliac Aneurysms with an Iliac Side-branched Stent graft: Studying the Morphological Applicability of the Cook Device. Eur J Vasc Endovasc Surg 2015; 49:283-8. [DOI: 10.1016/j.ejvs.2014.12.021] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 12/15/2014] [Indexed: 11/29/2022]
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15
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Gautier P, Repesse Y, Joguet E, Troussard X, Borel-Derlon A, Berger L. Endovascular abdominal aortic aneurysm repair in a mild haemophilia A patient: a case report. Haemophilia 2015; 21:e232-e235. [PMID: 25684019 DOI: 10.1111/hae.12640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2015] [Indexed: 11/29/2022]
Affiliation(s)
- P Gautier
- Biological hematology department, CHU Caen, Caen, France; Hemophilia Centre, CHU Caen, Caen, France
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