Anton Susanne, Wiedner Marcus, Stahlberg Erik, Jacob Fabian, Barkhausen Jörg, Goltz Jan Peter
Clinic for Radiology and Nuclear Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Clinic for Surgery, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Cardiovasc Intervent Radiol. 2018 May;41(5):683-691. doi: 10.1007/s00270-017-1868-x. Epub 2018 Jan 3.
Occlusion of internal iliac arteries during endovascular treatment (EVAR) of abdominal aortic (AAA) and common iliac artery aneurysms might be associated with ischemic pelvic complications. This study evaluates technical and clinical success, safety and mid-term results of a novel iliac branch device (IBD) for revascularization of the internal iliac artery (IIA) during EVAR.
Retrospectively, we identified 21 men (mean age 73.3 ± 6.2 years) treated for aorto-iliac aneurysms by use of a novel IBD (E-liac, Jotec Hechingen, Germany). We analyzed safety (30-day survival), technical (no type I and III endoleaks, "EL"), clinical (no ischemic complications) success, mid-term patency of this IBD, peri-procedural complications, occurrence of type II ELs, rate of re-interventions and additional treatment of the revascularized IIA for landing zone preparation.
Twenty-three IBDs were implanted. Aneurysms of the ipsilateral IIA were present in 6/23 IIAs (26.1%). Super-selective branch embolization was performed in these patients and the landing zone for the iliac sidebranch stent-graft was within the superior gluteal artery. Mean follow-up was 341 days (range 4-1103 days). Technical success and 30-day survival were 100%. Clinical success was 95.2%. Primary patency of the IBDs was 100% at 12 months. Peri-procedural complications occurred in 3/21 patients (14.3%), none of them related to the IBD. AAA-related type II ELs were found in 6 patients (28.6%), IBD-related ELs in 4/23 IBDs (17.4%) (two type Ib, two type II endoleaks). Overall re-intervention rate was 23.8%, IBD-related 8.7%.
Utilization of the E-liac IBD is safe and effective for the treatment of aorto-iliac aneurysms.
腹主动脉瘤(AAA)和髂总动脉瘤腔内治疗(EVAR)期间髂内动脉闭塞可能与缺血性盆腔并发症相关。本研究评估一种新型髂支装置(IBD)在EVAR期间用于髂内动脉(IIA)血运重建的技术和临床成功率、安全性及中期结果。
我们回顾性纳入了21例男性患者(平均年龄73.3±6.2岁),这些患者采用新型IBD(E-liac,德国约泰克黑兴根公司)治疗主髂动脉瘤。我们分析了安全性(30天生存率)、技术成功率(无I型和III型内漏,“EL”)、临床成功率(无缺血性并发症)、该IBD的中期通畅率、围手术期并发症、II型EL的发生情况、再次干预率以及为准备着陆区对血运重建的IIA进行的额外治疗。
共植入23个IBD。23条IIA中有6条(26.1%)存在同侧IIA动脉瘤。对这些患者进行了超选择性分支栓塞,髂侧支支架移植物的着陆区位于臀上动脉内。平均随访341天(范围4 - 1103天)。技术成功率和30天生存率均为100%。临床成功率为95.2%。IBD在12个月时的原发性通畅率为100%。3/21例患者(14.3%)发生围手术期并发症,均与IBD无关。6例患者(28.6%)发现与AAA相关的II型EL,4/23个IBD(17.4%)发现与IBD相关的EL(2例Ib型,2例II型内漏)。总体再次干预率为23.8%,与IBD相关的为8.7%。
使用E-liac IBD治疗主髂动脉瘤安全有效。