Technical and outcome considerations of endovascular treatment for internal iliac artery aneurysms

Akhmadu Muradi, Masato Yamaguchi, Takuya Okada, Yoshikatsu Nomura, Koji Idoguchi, Eisuke Ueshima, Noriaki Sakamoto, Ryota Kawasaki, Yutaka Okita, Koji Sugimoto

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

Abstract

Purpose: This study was designed to analyze the outcomes of endovascular treatment for internal iliac artery aneurysm (IIAA) at mid-term follow-up. Methods: We retrospectively analyzed 33 patients (28 males, mean age 77.4 years) who underwent endovascular treatment of 35 IIAAs (mean diameter 39.8 mm) from 2002 to 2012. We attempted to completely and selectively embolize all distal branches with permanent embolic materials, followed by proximal controls either by stent-graft placement (type 1) or coil embolization (type 2). Results: Procedural success rate was 97.1 % (n = 34). Complete permanent distal branches embolization was achieved in 27 (79.4 %), type 1 in 24 (70.6 %), and type 2 in 10 (29.4 %) cases. During mean follow-up period of 29.1 months (range, 1.2-92.8), no IIAA-related mortality and stent/stent-graft related complications occurred. Pelvic ischemia occurred and resolved in 8 (25 %) patients. Among 32 cases followed by CT, the aneurysm diameter was stable in 18 (56.3 %), shrank in 11 (34.4 %), and enlarged in 3 (9.4 %) cases. In 22 assessed by contrast-enhanced CT, secondary endoleak occurred in 3 (13.6 %) cases and 2 required secondary interventions (2/32, 6.3 %). Type 1 procedure tends to have better mid-term outcomes. Incomplete permanent distal branches embolization was associated with enlargement and secondary intervention (p = 0.007 and p = 0.042, respectively). The secondary intervention-free rate at 3 years in the complete and incomplete distal embolization group was 100 and 83.3 %, respectively (p = 0.128). Conclusions: Endovascular treatment for IIAA is feasible and safe. Complete permanent distal branches embolization is important to achieve satisfactory mid-term outcomes.

Original languageEnglish
Pages (from-to)348-354
Number of pages7
JournalCardioVascular and Interventional Radiology
Volume37
Issue number2
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Complete permanent embolization
  • Endovascular treatment
  • Internal iliac artery aneurysm
  • Mid term outcomes

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