1 Department of Vascular Surgery, Catharina Hospital, Eindhoven, the Netherlands.
2 Department of Epidemiology, CAPHRI Research School, Maastricht University, Maastricht, the Netherlands.
J Endovasc Ther. 2019 Apr;26(2):238-244. doi: 10.1177/1526602819833068.
To analyze the results of endovascular repair of common iliac artery (CIA) aneurysms without preemptive coil embolization of the internal iliac artery (IIA).
Between January 2010 and July 2016, 79 patients (mean age 74.3±8.4 years; 76 men) underwent endovascular repair extending into the external iliac artery owing to a CIA aneurysm. The procedure was performed for a ruptured aneurysm in 22 (28%) patients. Eighty-one IIAs were intentionally covered. The median CIA diameter was 37 mm (range 20-90). The primary outcomes were the occurrence of type II endoleaks and the incidence of buttock claudication.
Five (6%) patients died within 30 days (4 with ruptured aneurysms and 1 elective case). Two type II endoleaks originating from a covered IIA were recorded; one required an endovascular intervention because of aneurysm growth. The other patient died of a rupture based on an additional type III endoleak. Mean follow-up was 37.6±26.3 months. Nineteen (26%) patients required a secondary intervention. Buttock claudication was reported in 21 (28%) of 74 patients and persisted after 1 year in 7. No severe ischemic complications as a result of IIA coverage were recorded, and no revascularization was required during follow-up.
Treatment of CIA aneurysms by overstenting the IIA without preemptive coil embolization is safe and has a low risk of type II endoleak and aneurysm growth. Persisting buttock claudication is rare.
分析不预先进行髂内动脉（IIA）线圈栓塞而对髂总动脉（CIA）动脉瘤进行血管内修复的结果。
2010 年 1 月至 2016 年 7 月，79 例（平均年龄 74.3±8.4 岁；76 例男性）因 CIA 动脉瘤而进行了血管内修复，延伸至髂外动脉。22 例（28%）患者因破裂性动脉瘤而行该手术。81 例 IIA 被故意覆盖。CIA 直径中位数为 37mm（范围 20-90）。主要结果是 II 型内漏的发生和臀跛行的发生率。
5 例（6%）患者在 30 天内死亡（4 例为破裂性动脉瘤，1 例为择期病例）。记录了 2 例起源于被覆盖的 IIA 的 II 型内漏，其中 1 例因动脉瘤生长而需要血管内干预。另一名患者因额外的 III 型内漏而死于破裂。平均随访时间为 37.6±26.3 个月。19 例（26%）患者需要二次干预。74 例中有 21 例（28%）报告臀跛行，且 1 年后仍持续存在。无 IIA 覆盖导致的严重缺血并发症，且在随访期间无需再次血运重建。
对 CIA 动脉瘤进行 IIA 过度支架置入而不预先进行线圈栓塞是安全的，其 II 型内漏和动脉瘤生长的风险较低。持续性臀跛行罕见。
