Department of Vascular Surgery, St. Franziskus Hospital Münster, Center of Vascular and Endovascular Surgery, Münster University Hospital, Münster, Germany.
J Vasc Surg. 2011 May;53(5):1223-9. doi: 10.1016/j.jvs.2010.10.121. Epub 2011 Jan 26.
To evaluate early and late results of open (OR) and endovascular aneurysm repair by iliac side branch device (EVRISB) for aneurysms involving the iliac bifurcation (AIB).
Between January 2004 and March 2010, 118 patients were diagnosed with AIBs and underwent OR or EVRISB at two European vascular centers. Particularly, 64 (54.2%) patients were treated by EVRISB and 54 (45.8%) by OR. In one center, 24 consecutive patients were treated by surgery because this was the standard therapeutic approach until January 2005. For the rest of the study period until March 2010, 64 consecutive patients with AIB suitable for EVRISB underwent placement of branched devices. In the other center, 30 consecutive patients with AIBs were treated by OR because advanced endovascular imaging was not available during the study period.
No significant differences in demographics, anatomical characteristics, or comorbidities of the patients were recorded between the two groups. Early (30-day) mortality was 0% for EVRISB versus 5.5% for the OR group (P < .001). Major morbidity occurred in 4.6% versus 9.3% of the patient subgroups, respectively (P < .001). Buttock claudication and colonic ischemia were recorded in 5.9% and 2% of OR patients compared with 3.1% and 0% of EVRISB cases (P > .05). Primary patency rates were 98.4% for EVRISB and 100% for OR patients. Primary and secondary endoleak rates of the EVRISB group were 12.5% and 6.3%, respectively.
Endovascular repair by iliac branch device of aneurysms involving the iliac bifurcation can be accomplished with very low morbidity and mortality rates. Especially for young active patients or in cases of contralateral occlusion, the preservation of hypogastric artery seems to be a strong argument for use of EVRISB as a preferable therapy option.
评估开放式（OR）和腹主动脉瘤腔内修复术加髂内分支装置（EVRISB）治疗髂分叉动脉瘤（AIB）的早期和晚期结果。
2004 年 1 月至 2010 年 3 月，在欧洲的两个血管中心，有 118 例 AIB 患者接受了 OR 或 EVRISB 治疗。其中，64 例（54.2%）患者接受了 EVRISB 治疗，54 例（45.8%）患者接受了 OR 治疗。在一个中心，24 例连续患者接受了手术治疗，因为这是 2005 年 1 月之前的标准治疗方法。在研究期间的其余时间，直到 2010 年 3 月，有 64 例适合 EVRISB 的 AIB 连续患者接受了分支装置的放置。在另一个中心，30 例 AIB 连续患者接受了 OR 治疗，因为在研究期间没有先进的血管内成像。
两组患者在人口统计学、解剖学特征或合并症方面无显著差异。EVRISB 的早期（30 天）死亡率为 0%，而 OR 组为 5.5%（P<.001）。主要发病率分别为 4.6%和 9.3%（P<.001）。OR 组 5.9%的患者出现臀部跛行，2%的患者出现结直肠缺血，而 EVRISB 组分别为 3.1%和 0%（P>.05）。EVRISB 组的一期通畅率为 98.4%，OR 组为 100%。EVRISB 组的一期和二期内漏发生率分别为 12.5%和 6.3%。
血管内修复术加髂内分支装置治疗涉及髂分叉的动脉瘤，其发病率和死亡率非常低。对于年轻活跃的患者或对侧闭塞的情况下，保存髂内动脉似乎是使用 EVRISB 作为首选治疗方案的一个强有力的论据。
