Department of Vascular Surgery, University Hospital of Lyon, Lyon, France.
Eur J Vasc Endovasc Surg. 2013 Jan;45(1):22-7. doi: 10.1016/j.ejvs.2012.10.006. Epub 2012 Oct 30.
There is no standardised technique for internal iliac artery aneurysm (IIAA) embolisation and results of long-term prevention of rupture are unknown.
We retrospectively evaluated technical aspects and results of IIAA embolisation in a multicentre study.
Aneurysm morphology and embolisation techniques were reviewed. Aneurysm-related death, rupture, diameter increase, endoleak, secondary procedure and complication related to the IIA occlusion were recorded.
Between 2001 and 2011, 53 patients with 57 IIAA were treated. Mean diameter of IIAA was 41 mm (range: 25-88 mm). Embolisation techniques were distal and proximal occlusion (n = 24), proximal occlusion (n = 18) and sac packing (n = 15). Cumulative overall survival rate was 92% at 1 year, 83% at 3 years and 59% at 5 years. No cause of deaths was related to aneurysm. Aneurysm diameter increased in five patients and endoleak was observed in 11 patients. One secondary open conversion and five secondary endovascular procedures were performed for increase of diameter or proximal endoleak. Two patients experienced a disabling buttock claudication.
Embolisation of IIAA is safe in the short- and midterm. However, endoleak and aneurysm diameter increases are not rare. Yearly post-procedure computed tomography angiography seems appropriate.
目前对于髂内动脉瘤（IIAA）的栓塞治疗还没有标准化的技术，长期预防破裂的效果也不明确。
我们对一项多中心研究中 IIAA 栓塞治疗的技术方面和结果进行了回顾性评估。
回顾分析了动脉瘤形态和栓塞技术。记录了与动脉瘤相关的死亡、破裂、瘤径增大、内漏、二期手术以及与 IIA 闭塞相关的并发症。
2001 年至 2011 年间，53 例 57 个 IIAA 患者接受了治疗。IIAA 的平均直径为 41mm（范围：25-88mm）。栓塞技术包括远端和近端闭塞（n=24）、近端闭塞（n=18）和瘤腔填塞（n=15）。1 年、3 年和 5 年的累积总生存率分别为 92%、83%和 59%。无动脉瘤相关死亡。5 例患者瘤径增大，11 例患者出现内漏。为了处理瘤径增大或近端内漏，有 1 例患者进行了二期开放手术，5 例患者进行了二期血管内治疗。2 例患者出现了有症状的臀肌跛行。
IIAA 栓塞在短期和中期是安全的。然而，内漏和瘤径增大并不少见。每年进行一次栓塞治疗后的 CT 血管造影似乎是合适的。
