Document Detail


Large iliac arteries: a high-risk group for endovascular aortic aneurysm repair.
MedLine Citation:
PMID:  17924726     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To examine if the presence of large iliac arteries is a potential risk factor for the development of a type Ib endoleak (iliac sealing zone) or need for iliac artery-related secondary intervention in patients undergoing endovascular abdominal aortic aneurysm repair. METHODS: The medical notes and all preoperative and postoperative plain abdominal radiographs and computer tomographic scans were reviewed for a consecutive series of 100 patients (89 men; mean age 75 years, range 56-91) with large iliac arteries (mean 19.7 mm, range 16-22) who had Zenith endovascular stent-grafts inserted for management of aortoiliac aneurysmal disease from January 1999 until September 2002. Endpoints were all-cause mortality, aneurysm-related death, endoleak, secondary intervention, secondary interventions, and stent-graft migration. RESULTS: Mean follow-up was 30.1+/-8.3 months; at the last follow-up, 30% of patients were dead, 3% were aneurysm-related. Seven (7%) patients developed a type Ib endoleak, with the remainder being type II (29%), type Ia (2%), type III (1%), and type V (endotension, 1%). Eight (27.5%) type II endoleaks persisted, with the remainder closing spontaneously with sac shrinkage. The iliac artery-related secondary intervention rate was 10%, and the overall secondary intervention rate was 16%. CONCLUSION: Iliac arteries between 16 and 22 mm in diameter may be treated with a cuff to the iliac limb with an expectation of 90% efficacy. Surveillance is required, with a high index of suspicion for type 1b endoleaks. Early secondary iliac intervention with extension to the external iliac artery is recommended if there is an increase in sac size after 6 months.
Authors:
Ciaran O McDonnell; James B Semmens; Yvonne B Allen; Shirley J Jansen; D Mark Brooks; Michael M D Lawrence-Brown
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  14     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-10     Completed Date:  2008-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  625-9     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. ciaranomcdonnell@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal / mortality,  pathology,  radiography,  surgery*
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation / adverse effects*,  instrumentation
Dilatation, Pathologic
Female
Follow-Up Studies
Foreign-Body Migration / etiology
Humans
Iliac Artery / pathology*,  radiography
Male
Middle Aged
Reoperation
Risk Assessment
Risk Factors
Stents
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Western Australia / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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