Kim Hyeon Ju, Yun Woo-Sung, Kim Hyung-Kee
Division of Vascular Surgery, Department of Surgery, Kyungpook National University Hospital, Daegu, Korea.
Division of Vascular Surgery, Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
Vasc Specialist Int. 2023 Mar 6;39:2. doi: 10.5758/vsi.230002.
Considering the recent advancements in endovascular management of aortoiliac aneurysms, the use of an iliac branch device (IBD) to preserve pelvic blood flow and reduce complications caused by embolization of the internal iliac artery (IIA) is recommended by various guidelines. Although the outcomes reported following IBD placement are mainly positive and durable, IBD-specific complications such as a type Ic endoleak and associated reintervention may occur. Moreover, only one IBD device and one type of balloon-expandable bridging stent graft for IIA are currently available on the domestic market. Here we present two cases of type Ic endoleak following IBD placement. In both cases, IIA diameter was slightly larger than the basic instructions for use. Notably, the initial procedures were considered successful; however, type Ic endoleaks were detected on 1-month follow-up imaging. This finding emphasizes the need for a precise preoperative evaluation, intraoperative manipulation, and postoperative follow-up.
考虑到腹主动脉瘤血管内治疗的最新进展，各种指南都推荐使用髂支装置（IBD）来保留盆腔血流并减少因髂内动脉（IIA）栓塞引起的并发症。尽管IBD置入术后报告的结果主要是积极且持久的，但仍可能发生IBD特异性并发症，如Ic型内漏及相关的再次干预。此外，目前国内市场上仅有一款IBD装置和一种用于IIA的球囊扩张式桥接支架移植物。在此，我们报告两例IBD置入术后发生Ic型内漏的病例。在这两例病例中，IIA直径均略大于基本使用说明中的规定。值得注意的是，初始手术被认为是成功的；然而，在术后1个月的随访影像中检测到了Ic型内漏。这一发现强调了术前精确评估、术中操作及术后随访的必要性。
