Abstract
ObjectiveTo assess the therapeutic outcome after endovascular repair of iliac arterial lesions (IALs) using a self-expandable Nitinol stent graft system.MethodsBetween July 2006 and March 2013, 16 patients (13 males, mean age: 68 years) with a self-expandable Nitinol stent graft. A total of 19 lesions were treated: nine true aneurysms, two anastomotic aneurysms, two dissections, one arteriovenous fistula, two type 1B endoleaks after endovascular aneurysm repair, one pseudoaneurysm, and two perforations after angioplasty. Pre-, intra-, and postinterventional imaging studies and the medical records were analyzed for technical and clinical success and postinterventional complications.ResultsThe primary technical and clinical success rate was 81.3% (13/16 patients) and 75.0% (12/16), respectively. Two patients had technical failure due to persistent type 1A endoleak and another patient due to acute stent graft thrombosis. One patient showed severe stent graft kinking on the first postinterventional day. In two patients, a second intervention was performed. The secondary technical and clinical success rate was 87.5% (14/16) and 93.8% (15/16). The minor complication rate was 6.3% (patient with painful hematoma at the access site). The major complication rate was 6.3% (patient with ipsilateral deep vein thrombosis). During median follow-up of 22.4 months, an infection of the aneurysm sac in one patient and a stent graft thrombosis in another patient were observed.ConclusionEndovascular repair of various IALs with a self-expandable Nitinol stent graft is safe and effective.
Highlights
Iliac Arterial Lesions (IALs) are caused by various pathologies, including aneurysms, dissections, arteriovenous (AV) fistulas, pseudoaneurysms, and traumatic or atraumatic perforations [1,2,3,4]
The prevalence of solitary iliac artery aneurysms (IAAs) is approx. 0.03% and rare compared to aortic aneurysms [1,5]
This study investigated the therapeutic outcome after endovascular repair of various IALs using a self-expandable Nitinol stent graft system
Summary
Iliac Arterial Lesions (IALs) are caused by various pathologies, including aneurysms, dissections, arteriovenous (AV) fistulas, pseudoaneurysms, and traumatic or atraumatic perforations [1,2,3,4]. IALs require treatment to prevent complications such as fatal arterial bleeding in subjects with aneurysms and perforations or high-output cardiac failure in subjects with an AV fistula. All lesions can potentially be treated by open surgery This is a well-established and reliable treatment; it is a timeconsuming major procedure and requires general anesthesia. Endovascular repair of iliac lesions with stent graft placement is an effective minimally invasive option for treating IALs [8,9]. The self-expanding Fluency Plus stent graft (BARD Peripheral Vascular, Tempe, Arizona) is a versatile device for treating different lesions in different body regions [6,10,11]
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