Treatment options for isolated iliac artery aneurysms and their impact on aortic diameter after treatment

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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Endovascular Therapy for Spontaneous Ilio-Iliac Arteriovenous Fistula Due To Iliac Artery Aneurysm Rupture With Multi-Organ Dysfunction

Vascular and Endovascular Surgery ◽

10.1177/1538574420923833 ◽

2020 ◽

Vol 54 (6) ◽

pp. 519-524

Author(s):

Muhammad Tipu Rishi ◽

John Maijub ◽

S. Keisin Wang ◽

Andi Peshkepija ◽

Justin King ◽

...

Keyword(s):

Arteriovenous Fistula ◽

Organ Dysfunction ◽

Endovascular Therapy ◽

Iliac Artery ◽

Treatment Options ◽

Artery Aneurysm ◽

Organ Damage ◽

Iliac Vein ◽

Aneurysm Rupture ◽

Iliac Artery Aneurysm

Iliac artery aneurysms can rarely present with rupture into adjacent iliac vein resulting in arteriovenous fistula leading to acute cardiac failure or multi-organ failure. End-organ damage can be reversed with timely diagnosis and intervention. Endovascular therapy is an attractive option to treat this pathology besides allowing for a quick recovery and mitigating the risk of mortality associated with open surgical treatment options. We report treatment of this pathology with Endovascular repair with preservation of ipsilateral hypogastric artery flow using an iliac branch graft device. The postoperative course was complicated by type 3 endoleak due to the separation of components between iliac branch graft and aortic stent graft with resultant recurrence of the fistula. Additional endovascular techniques, including placement of a venous stent and stent grafts to bridge the components, was used to treat the endoleak. We present this report due to the unique nature of the recurrent arteriovenous fistula, technical complexity, and resultant multi-organ dysfunction.

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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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