Primary Endovascular Elective Repair and Repair of Ruptured Isolated Iliac Artery Aneurysms Is Durable—Results of 72 Consecutive Patients

Objective: To review the experience of our institution in repairing isolated iliac artery aneurysm (isolated IAA) in the last 10 years. Introduction: Unlike abdominal and combined aortoiliac artery aneurysms, isolated iliac artery aneurysms (IIAAs) are uncommon. An isolated iliac artery aneurysm is dened as a twofold increase in the diameter of the iliac artery without a coexisting aneurysm at another location. IIAA was encountered infrequently in the past, comprising 0.9% to 4.7% of all intra-abdominal aneurysms according to a review of previous studies; however, in recent times, many asymptomatic IIAAs have been detected incidentally because of the widespread use of abdominal ultrasonography and computed tomography. Methods: The medical records of patients who underwent isolated IAA repair at Institute of vascular sciences, MMC and RGGGH, Chennai, India, were reviewed, to obtain information on patients' demographics, vascular risk factors, type of treatment and outcome Results: A total of 13 patients with 18 aneurysms, 11 men(84.6%) 2 women(15.4%), with a mean age of 58.1±6 years, and two paediatric patients of age 11yrs (Female) and 3 months (Male) were treated. The mean diameter was 4.6 ± 1.0 for non-ruptured at elective repair; 5.5±2.1 cm on the emergency cases. The majority of aneurysms were at the common iliac artery. All of them except one, underwent open repair.Ten (84%) had elective operations, and two (16%) emergency repair for ruptured aneurysm. Hypertension and diabetes were seen as the most common risk factors with most of the patients were smokers. One was a known case of CKD and the paediatric female was a known case of RHD. There was one postoperative death in this series, patient succumbed on POD 1. Conclusion: This case series reviews the literature with regard to the natural history, diagnostic workup, and treatment of iliac artery aneurysms. For patients undergoing elective repair, preoperative imaging with computed tomography or magnetic resonance is advocated. Repair is recommended for good-risk patients with aneurysms larger than 3.5 cm as there is high chances of rupture with increasing diameter.

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Isolated Iliac Artery Aneurysms

Haimovici's Vascular Surgery ◽

10.1002/9780470755815.ch63 ◽

2008 ◽

pp. 763-766 ◽

Cited By ~ 1

Author(s):

Henry Haimovici

Keyword(s):

Iliac Artery ◽

Isolated Iliac Artery Aneurysms

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Strategy for Isolated Iliac Artery Aneurysms

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230701500403 ◽

2007 ◽

Vol 15 (4) ◽

pp. 280-284 ◽

Cited By ~ 12

Author(s):

Shinichi Hiromatsu ◽

Yukio Hosokawa ◽

Noriko Egawa ◽

Hiroko Yokokura ◽

Keiichi Akaiwa ◽

...

Keyword(s):

Iliac Artery ◽

Common Iliac Artery ◽

Abdominal Aortic Aneurysms ◽

Prosthetic Graft ◽

Aortic Aneurysms ◽

Abdominal Aortic ◽

Internal Iliac ◽

Stent Graft Repair ◽

The Common ◽

Isolated Iliac Artery Aneurysms

We retrospectively reviewed 41 patients with isolated iliac artery aneurysms presenting over a 21-year period. The mean age was 72 years. Mean aneurysmal diameter was 6.0 cm (range, 3.2–13 cm). The aneurysms were located in the common iliac artery in 31 patients, internal iliac artery in 7, and both arteries in 3. Rupture occurred in 20 patients (49%). The frequency of rupture of isolated iliac artery aneurysms was significantly higher than that of abdominal aortic aneurysms (8%) during the same period. The 30-day mortality was 9.8%; death in all 4 patients was due to rupture of the aneurysm. The surgical procedure was aneurysmectomy and replacement with a bifurcated prosthetic graft in 24 patients (59%), closure of the common iliac artery with a femorofemoral crossover in 7, minilaparotomy in 3, thromboexclusion in 6, and endoluminal stent-graft repair in one. In contrast to abdominal aortic aneurysms, isolated iliac artery aneurysms can be treated by various methods other than replacement with a bifurcated prosthetic graft. When selecting a strategy for such aneurysms, it is important to choose an approach appropriate to the location and risk, because of the frequency of rupture.

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Long-term efficacy of endovascular treatment of isolated iliac artery aneurysms

La radiologia medica ◽

10.1007/s11547-012-0813-1 ◽

2012 ◽

Vol 118 (1) ◽

pp. 62-73 ◽

Cited By ~ 9

Author(s):

R. Fossaceca ◽

G. Guzzardi ◽

M. Di Terlizzi ◽

I. Divenuto ◽

P. Cerini ◽

...

Keyword(s):

Endovascular Treatment ◽

Iliac Artery ◽

Term Efficacy ◽

Isolated Iliac Artery Aneurysms

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Outcomes after Standalone Use of Gore Excluder Iliac Branch Endoprosthesis for Endovascular Repair of Isolated Iliac Artery Aneurysms

Annals of Vascular Surgery ◽

10.1016/j.avsg.2020.03.023 ◽

2020 ◽

Vol 67 ◽

pp. 158-170

Author(s):

Mario D'Oria ◽

Emanuel R. Tenorio ◽

Gustavo S. Oderich ◽

Randall R. DeMartino ◽

Manju Kalra ◽

...

Keyword(s):

Iliac Artery ◽

Endovascular Repair ◽

Isolated Iliac Artery Aneurysms

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Standard of Practice for the Interventional Management of Isolated Iliac Artery Aneurysms

CardioVascular and Interventional Radiology ◽

10.1007/s00270-010-0055-0 ◽

2010 ◽

Vol 34 (1) ◽

pp. 3-13 ◽

Cited By ~ 50

Author(s):

Raman Uberoi ◽

Dimitrios Tsetis ◽

Vivek Shrivastava ◽

Robert Morgan ◽

Anna-Maria Belli

Keyword(s):

Iliac Artery ◽

Interventional Management ◽

Standard Of Practice ◽

Isolated Iliac Artery Aneurysms

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Endovascular treatment of isolated iliac artery aneurysms using a custom-made stent graft with proximal barb fixation: early outcome

Vascular ◽

10.1177/1708538113478720 ◽

2013 ◽

Vol 21 (2) ◽

pp. 92-96 ◽

Cited By ~ 3

Author(s):

D L H Baird ◽

K Mani ◽

T Sabharwal ◽

P R Taylor ◽

H A Zayed

Keyword(s):

Stent Graft ◽

Iliac Artery ◽

Perioperative Complications ◽

External Iliac Artery ◽

Stent Grafts ◽

Landing Zone ◽

Custom Made ◽

Internal Iliac ◽

The Mean ◽

Isolated Iliac Artery Aneurysms

Current endovascular treatments for isolated iliac artery aneurysms (IIAAs) include the use of aortoiliac stent grafts with coverage of the distal aorta or stent grafts confined to the iliac artery without active proximal fixation. We report our experience in the use of custom-made Cook Zenith™ iliac limb stent grafts with proximal barb fixation. Patients treated from July 2009 to February 2011 were included. All imaging and patient records were assessed for perioperative and early outcomes. Nine IIAAs (seven patients) were treated. The mean patient age was 80 years (range 58-91 years). The mean aneurysm size was 48 mm (35-80 mm), and the mean length of the proximal landing zone (PLZ) was 29 mm (10-50 mm). The distal landing zone was in the external iliac artery after coil embolization of the internal iliac artery. The Mean diameter of the PLZ was 21 mm (20-24 mm). Technical success was achieved in eight cases. Perioperative complications included reoperation in one patient for groin bleeding and ischemia. On follow-up (mean 12 months, range 1-26), all aneurysms were successfully excluded from the circulation and there was no stent graft migration or thrombosis. Use of custom-made stent grafts with proximal barb fixation in treatment of IIAAs is a feasible option which may reduce the risk of migration when compared with stent grafts with lack of proximal fixation.

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