Endovascular treatment of common iliac artery aneurysms with an iliac branch device: Multicenter experience of 140 patients

Hidde Jongsma, Joost A. Bekken, Wouter J.J. Bekkers, Clark J. Zeebregts, Joost Van Herwaarden, Arjan Hoksbergen, Philip Cuypers, Jean Paul P.M. De Vries, Hence J. Verhagen, Bram Fioole

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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.

Original languageEnglish
Pages (from-to)239-245
Number of pages7
JournalJournal of endovascular therapy
Volume24
Issue number2
DOIs
Publication statusPublished - 2017

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

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