| Large iliac arteries: a high-risk group for endovascular aortic aneurysm repair. | |
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MedLine Citation:
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PMID: 17924726 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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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:
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Created Date: 2007-10-10 Completed Date: 2008-01-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100896915 Medline TA: J Endovasc Ther Country: United States |
Other Details:
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Languages: eng Pagination: 625-9 Citation Subset: IM |
Affiliation:
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Department of Vascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. ciaranomcdonnell@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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