Wu Mingwei, Ren Luxia, Wang Haibo, Xiong Jiang
Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, China.
Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, China.
Eur J Vasc Endovasc Surg. 2025 May;69(5):704-711. doi: 10.1016/j.ejvs.2024.09.024. Epub 2024 Sep 20.
This study aimed to identify the iliac artery characteristics of East Asian patients with abdominal aortic aneurysms (AAAs) and to evaluate anatomical suitability rates with current iliac branch devices (IBDs).
This was a single centre, retrospective, cross sectional study. Patients diagnosed with AAA between 2008 and 2023 were enrolled. The morphological parameters of the iliac arteries were measured, and their eligibility for four IBDs (Cook ZBIS, Gore IBE, E-Liac IBD, and G-Iliac IBD) was evaluated according to the manufacturer's latest instructions for use (IFU).
Among 1 144 AAAs observed in the study, 45.5% (n = 521) presented with concurrent common iliac artery aneurysm (CIAA). In total, 304 patients (26.6%) and 371 iliac arteries necessitated internal iliac artery (IIA) reconstruction. The anatomical suitability rates for the Cook ZBIS, Gore IBE, E-Liac IBD, and G-Iliac IBD were 18.9%, 21.8%, 11.9%, and 22.6%, respectively. The E-Liac IBD exhibited a significantly lower anatomical suitability rate compared with the other three devices (p < .001). The primary IBD exclusion criteria were: a common iliac artery (CIA) length of < 50 mm for Cook ZBIS (n = 211, 56.9%); an IIA diameter of < 6.5 mm or > 13.5 mm for Gore IBE (n = 177, 47.7%); and a CIA bifurcation diameter of < 18 mm both for E-Liac IBD and G-Iliac IBD (n = 244, 65.8%). A total of 198 patients (53.4%) failed to meet the anatomical criteria for any device, while 112 (30.2%) qualified for just one device, 26 (7.0%) for two devices, 25 (6.7%) for three devices, and 10 (2.7%) for all four devices.
A significant proportion of East Asian patients with AAA present with concurrent CIAA, necessitating substantial IIA reconstruction. IBD techniques show low anatomical suitability rates among the East Asian population, with 53.4% of patients failing to meet anatomical criteria for any IBD based on the manufacturer's IFU.
本研究旨在确定东亚腹主动脉瘤（AAA）患者的髂动脉特征，并评估当前髂支装置（IBD）的解剖学适配率。
这是一项单中心、回顾性横断面研究。纳入2008年至2023年间诊断为AAA的患者。测量髂动脉的形态学参数，并根据制造商最新的使用说明书（IFU）评估其使用四种IBD（库克ZBIS、戈尔IBE、E-Liac IBD和G-Iliac IBD）的适配性。
在本研究观察的1144例AAA患者中，45.5%（n = 521）同时存在髂总动脉瘤（CIAA）。共有304例患者（26.6%）和371条髂动脉需要进行髂内动脉（IIA）重建。库克ZBIS、戈尔IBE、E-Liac IBD和G-Iliac IBD的解剖学适配率分别为18.9%、21.8%、11.9%和22.6%。与其他三种装置相比，E-Liac IBD的解剖学适配率显著较低（p < 0.001）。IBD的主要排除标准为：库克ZBIS的髂总动脉（CIA）长度<50 mm（n = 211，56.9%）；戈尔IBE的IIA直径<6.5 mm或>13.5 mm（n = 177，47.7%）；E-Liac IBD和G-Iliac IBD的CIA分叉直径均<18 mm（n = 244，65.8%）。共有198例患者（53.4%）不符合任何一种装置的解剖学标准，而112例（30.2%）仅符合一种装置的标准，26例（7.0%）符合两种装置的标准，25例（6.7%）符合三种装置的标准，10例（2.7%）符合所有四种装置的标准。
相当一部分东亚AAA患者同时存在CIAA，需要大量的IIA重建。IBD技术在东亚人群中的解剖学适配率较低，53.4%的患者根据制造商的IFU不符合任何IBD的解剖学标准。
