Department of Vascular and Endovascular Surgery, Klinik Ottakring, Vienna, Austria.
Vascular and Endovascular Surgery, Marien-Hospital Witten, Witten, Germany.
Interact Cardiovasc Thorac Surg. 2021 Aug 18;33(3):448-454. doi: 10.1093/icvts/ivab115.
The aim of this study was to present a multicentre experience of technical results and mid-term follow-up using a custom-made iliac fenestrated device (Terumo Aortic, Inchinnan, Renfrewshire, UK) for the treatment of iliac aneurysms and endoleaks.
A multicentre retrospective evaluation of 22 patients (3-12 per institution) with either an iliac artery aneurysm or endoleak treated with an iliac fenestrated device was performed. Data were gathered from 3 departments of vascular and endovascular surgery at 3 European institutions.
Ten of the included patients (45.5%) were treated for an endoleak and 12 had aorto-iliac aneurysms (54.5%). Two patients underwent bilateral fenestrated device implantation for a total of 24 devices included in this analysis. Primary technical success was 91.7% (22 of 24 implanted devices). One of the 24 internal iliac arteries could not be cannulated and was covered (primary assisted technical success rate 95.8%) and 1 patient required a relining of the stent graft due to a mid-grade stenosis opposite the internal iliac artery fenestration. Survival at the last available follow-up (mean 15.2 ± 12.0 months, range 0.5-36.6 months) was 90.9%.
The present investigation adds to a growing body of literature on custom-made endografts and their usefulness in achieving endovascular repair without compromising blood flow via important arterial branch vessels, such as the internal iliac artery. It presents encouraging technical and mid-term follow-up data from consecutive patients treated for iliac aneurysms or endoleaks using this custom-made device. The technique may help avoid adverse sequelae associated to a coil-and-cover approach when iliac branch devices are not feasible.
本研究旨在介绍使用定制的髂动脉开窗支架（英国 Renfrewshire 郡 Inchinnan 的 Terumo Aortic）治疗髂动脉瘤和内漏的多中心技术结果和中期随访经验。
对在欧洲 3 家医疗机构的 3 个血管和血管内外科部门接受髂动脉开窗支架治疗的 22 例（每个机构 3-12 例）患者进行了多中心回顾性评估。收集了 3 个部门的数据。
22 例患者中 10 例（45.5%）接受了内漏治疗，12 例患有腹主动脉-髂动脉瘤（54.5%）。2 例患者接受了双侧开窗支架植入，共有 24 个支架被纳入本分析。24 个内置髂动脉中有 1 个无法进行血管内操作并被覆盖（主要技术成功率为 91.7%），1 例患者由于内置髂动脉开窗处的中度狭窄需要重新放置支架。最后一次随访时的生存率为 90.9%（24 例中 22 例）。
本研究增加了关于定制内支架及其在不影响重要动脉分支（如髂内动脉）血流的情况下实现血管内修复的有效性的文献。它提供了令人鼓舞的技术和中期随访数据，连续治疗了髂动脉瘤或内漏患者，使用这种定制设备。该技术可能有助于避免在髂支装置不可行时，使用线圈和覆盖方法所带来的不良后果。
