A Case of Open Surgery for Bilateral Internal Iliac Artery Aneurysms Complicated with Urinary Retention and Constipation

Objectives: The purpose of this paper is to report the different modalities for the treatment of isolated internal iliac artery aneurysms (IIIAA), as well as their outcomes. Methods: We performed a systematic review of the literature (database searched: PubMed, Web of Science, Scopus, Cochrane Library; last search: April 2020). We included articles reporting on the outcomes for IIIAA interventions comprising at least 5 patients. Studies were included when presenting extractable outcome data regarding intraoperative and/or early results. We performed meta-analyses of proportions for different outcomes, using random effects model. Results: Thirteen non-randomized studies were included (192 patients with 202 IIIAA). IIIAA were symptomatic in the 18.1% (95%CI 9.3-26.9; I2 54.46%, P = .019). Estimated mean IIIAA diameter was 46.28 mm (95%CI 39.72-52.85; I2 88.85%, P < .001). Open repair was performed in 21/202 cases. Endovascular treatments were: embolization (81/181), embolization and hypogastric artery coverage (79/181), hypogastric artery coverage by stent-grafting (15/181), stent-grafting in the hypogastric artery (6/181). Overall estimated technical success (TS) rate was 91.6% (95% CI 86.8-95.5; I2 45.82%, P = .031). TS rate was 94.5% for open surgery (95%CI 85.3-100; I2 0%, P = .907), and 89.7% for endovascular repair (95%CI 83.8-95.6; I2 55.43%, P = .006). Estimated overall 30-day mortality was 3.1% (95%CI 0.8-5.4; I2 0%, P = .969). Mortality rates after open surgery and endovascular repair were 8.2% (95%CI 3.4-19.8; I2 0%, P = .545) and 2.8% (95%CI 0.5-5.1; I2 0%, P = .994), respectively. Estimated mean follow-up was 32.63 months (95%CI 21.74-43.53; I2 94.45%, P < .001). During this timeframe, IIIAA exclusion was preserved in 92.8% of the patients (95%CI 89.3-96.2; I2 0%, P = .797). Buttock claudication occurred in 13.9% of the patients (95%CI 8.7-19.2; I2 0%, P = .622). Conclusions: IIIAA are frequently large, and symptomatic at presentation. Several treatments are proposed in literature, open and endovascular, both with good results. The endovascular treatment is the preferred method of treatment in literature, since it offers good short- to mid-term results and low early mortality. Buttock claudication after hypogastric artery exclusion is a common complication.

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Management of Type II Endoleak From Internal Iliac Artery Immediately After Endovascular Aneurysm Repair

Vascular and Endovascular Surgery ◽

10.1177/1538574416687736 ◽

2017 ◽

Vol 51 (1) ◽

pp. 47-50 ◽

Cited By ~ 2

Author(s):

Ming-Yi Hsu ◽

Ta-Wei Su ◽

I-Hao Su ◽

Po-Jen Ko ◽

Sung-Yu Chu

Keyword(s):

Iliac Artery ◽

Coil Embolization ◽

Open Surgery ◽

Internal Iliac Artery ◽

Endovascular Aneurysm Repair ◽

Type Ii ◽

Type Ii Endoleak ◽

Internal Iliac ◽

A New Technique ◽

Aneurysm Repair

Inadvertent coverage of origin of internal iliac artery (IIA) during endovascular aneurysm repair may lead to type II endoleak. Except for open surgery, the endovascular solution is limited. We report a case with such complication that was successfully treated with coil embolization using retrograde extrastent approach. This is a new technique that has not been reported before, and as such, had been useful in the treatment of type II endoleak from IIA as an alternative to open ligation of IIA origin.

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Internal iliac artery aneurysms: open surgery or endovascular repair?

ANZ Journal of Surgery ◽

10.1111/j.1445-2197.2009.04845.x ◽

2009 ◽

Vol 79 (4) ◽

pp. 219-220

Keyword(s):

Iliac Artery ◽

Endovascular Repair ◽

Open Surgery ◽

Internal Iliac Artery ◽

Internal Iliac

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Isolated Internal Iliac Artery False Aneurysm Presenting as Urinary Retention

EJVES Extra ◽

10.1016/j.ejvsextra.2004.06.006 ◽

2004 ◽

Vol 8 (4) ◽

pp. 86-89

Author(s):

B.P. Mwipatayi ◽

N.G. Naidoo ◽

C. Dreyer ◽

S. Jadwat ◽

S.J. Beningfield

Keyword(s):

Urinary Retention ◽

Iliac Artery ◽

False Aneurysm ◽

Internal Iliac Artery ◽

Internal Iliac

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The outcomes of internal iliac artery preservation during endovascular or open surgery treatment for aortoiliac aneurysms

Jornal Vascular Brasileiro ◽

10.1590/1677-5449.200087 ◽

2020 ◽

Vol 19 ◽

Author(s):

Rafael de Athayde Soares ◽

Marcelo Fernando Matielo ◽

Francisco Cardoso Brochado Neto ◽

Amanda Thurler Palomo ◽

Rodrigo Andrade Lourenço ◽

...

Keyword(s):

Intensive Care Unit ◽

Overall Survival ◽

Cohort Study ◽

Iliac Artery ◽

Open Surgery ◽

Internal Iliac Artery ◽

Bowel Ischemia ◽

Post Procedure ◽

Buttock Claudication ◽

Internal Iliac

Abstract Background Internal iliac artery (IIA) preservation continues to be a challenge during open surgery or endovascular repair of abdominal aortoiliac aneurysm (AAIA). Objectives To determine the results in terms of survival and clinical outcomes in patients with aortoiliac aneurysms (AAIA) treated with endovascular (EV) or open surgical (OS) repair. Methods This was a retrospective consecutive cohort study of patients with AAIA who underwent EV or OS repair. Results Post-procedure hospitalization time and intensive care unit stay were both longer in the OS group than in the EV group (7.08 ± 3.5 days vs. 3.32 ± 2.3 days; p = 0.03; 3.35 ± 2.2 days vs. 1.2 ± 0.8 days; p = 0.02, respectively). There were two cases of bowel ischemia (4.7%; OS 8.3% and EV 3.2%; p = 0.48), two cases of buttock claudication (4.7%; OS 8.3% and EV 3.2%; p = 0.48), and one case of sexual dysfunction (2.3% OS), all of them in patients with bilateral occlusion of the internal iliac artery (five patients, 11.6%; p = 0.035). Overall survival at 720 days was 80.6% in the EV group and 66.7% in the OS group (p = 0.58). Conclusions In the present study, OS and EV repair of aortoiliac aneurysms had similar overall survival and outcomes. Preservation of at least one internal iliac artery is associated with good results and no further complications.

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