Luan J Y, Li X, Xiang Y, Fu J, Wang C M, Li T R, Han J T
Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing 100191, China.
Department of Interventional Radiology, Anshun People's Hospital, Guizhou Anshun 561000, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2014 Dec 18;46(6):917-9.
To study the importance of the internal iliac artery (IIA) during the endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA).
Forty-six consecutive cases of AAA treated by EVAR were retrospectively analyzed. The complications after exclusion of the IIA were analyzed.
The bilateral IIAs were reserved in 18 cases, in which the follow-up was achieved in 16 cases and no complication was observed. The IIAs were excluded in 28 (60.9%) cases, in which the bilateral, right and left IIAs were excluded in 7 (15.2%), 14 (30.4%) and 7 (15.2%) cases respectively. The follow-up was achieved in 26 cases. Buttock claudication was observed in 12 (46.2%) cases, altered bowel habit was observed in 8 (32.0%) cases, erectile dysfunction was observed in 3 (12.0%) cases, and bloody stool was observed in 2 (8.0%) cases. Comparing the bilateral and unilateral IIA exclusions, the rates of buttock claudication were 50.0% vs. 45.0%, altered bowel habit 33.3% vs. 31.6%, and erectile dysfunction 33.3% vs. 5.3% respectively. And the average duration of buttock claudication of bilateral IIAs exclusion (8.3 months) was longer than that of unilateral exclusion (4.7 months). Moreover, comparing the left and right IIA exclusions, the rates of buttock claudication were 57.1% vs. 38.5%, altered bowel habit 57.1% vs. 16.7%, and bloody stool 28.6% vs. 0 respectively. And the average duration of buttock claudication of left IIA exclusion (6.0 months) was longer than that of right exclusion (3.7 months).
The IIAs, especially the left IIA, should be reserved during the EVAR for AAA.
研究在腹主动脉瘤（AAA）的血管腔内修复术（EVAR）中髂内动脉（IIA）的重要性。
回顾性分析46例连续接受EVAR治疗的AAA病例。分析排除IIA后的并发症。
18例保留双侧IIA，其中16例获得随访，未观察到并发症。28例（60.9%）排除IIA，其中双侧、右侧和左侧IIA分别在7例（15.2%）、14例（30.4%）和7例（15.2%）中被排除。26例获得随访。12例（46.2%）出现臀部跛行，8例（32.0%）出现排便习惯改变，3例（12.0%）出现勃起功能障碍，2例（8.0%）出现便血。比较双侧和单侧IIA排除情况，臀部跛行发生率分别为50.0%和45.0%，排便习惯改变分别为33.3%和31.6%，勃起功能障碍分别为33.3%和5.3%。双侧IIA排除后的臀部跛行平均持续时间（8.3个月）长于单侧排除（4.7个月）。此外，比较左侧和右侧IIA排除情况，臀部跛行发生率分别为57.1%和38.5%，排便习惯改变分别为57.1%和16.7%，便血分别为28.6%和0。左侧IIA排除后的臀部跛行平均持续时间（6.0个月）长于右侧排除（3.7个月）。
在AAA的EVAR中应保留IIA，尤其是左侧IIA。
