9:12 AM Abstract No. 21 - Preservation of the superior gluteal artery in patients with internal iliac artery aneurysm using iliac bifurcated device and viabahn stent grafts, a single institution experience

Abstract

Purpose To evaluate the feasibility and efficacy of extension of iliac branch graft (IBG) into the superior gluteal artery in endovascular repair of complex aortoiliac aneurysms Materials and Methods From May 2009 to December 2012, 7 men (mean age 76 years, range 69-85 y) were treated with IBG with stent graft extension into the superior gluteal artery. Indications were abdominal aneurysm with internal iliac artery aneurysm (n=5), repair of type III endoleak in a patient initially managed with EVAR and IBG alone (n=1), and expanding internal iliac aneurysm in a patient treated with a surgical aortobifemoral graft (n=1). Post-operative endoleak and patency rates were determined by CT (n=7) within 4 weeks of placement, with clinical follow-up for symptoms of pelvic ischemia. Average follow-up was 3.5 months (range 1 month - 15 months). Results Technical success, as defined by successful extension into the superior gluteal artery with no intraprocedural endoleak, was 100% (7/7). There were no cases of post-procedural endoleak. All stent-implanted internal iliac aneurysms remain stable in size, with no aneurysm rupture or death recorded. All superior gluteal artery stent grafts remain patent on follow-up CT angiography. None of the patients have new symptoms of pelvic ischemia. Conclusion Preservation of the superior gluteal artery is technically feasible with excellent short-term results in treatment of patients with aortoiliac aneurysms. This technique presents an opportunity for preservation of pelvic perfusion in patients with complex anatomy not amenable to conventional IBG placement in the internal iliac artery.