Resultados a corto y medio plazo en el tratamiento endovascular de aneurismas aortoiliacos o iliacos mediante el uso del dispositivo de rama iliaca

Abstract

ObjectiveAn iliac branch device (IBD) is used as a technique to avoid or minimise the complications associated with the occlusion of the hypogastric artery (HA). The purpose of this paper is to analyse the short and medium-term outcomes with the use of an IBD in our centre. Material and methodsA descriptive study that included 28 HA of 14 patients with an aorto-iliac aneurysm treated with an IBD between 2011 and 2015. There were 14 (100%) bilateral iliac artery aneurysms, 11 (78.6%) associated with an aortic aneurysm, and 4 (14.3%) with HA aneurysm. Of the 28 HA, 19 (67.8%) where treated with an IBD (5 bilateral), 4 (14.3%) were covered with the endoprosthesis, 2 (7.1%) were embolised, 2 were not treated, and one was treated with a covered stent graft in order to treat the hypogastric aneurysm. In all of the cases one HA was patent. An analysis is presented of the mortality, patency, endoleaks, buttock claudication, erectile dysfunction, and pelvic ischaemia. CT angiogram and doppler ultrasound were used in the follow-up. ResultsAll (100%) the patients were male, with a mean age of 74.6±13.6 years. Patency at one month was 94.7%, 80% at one year, and 77.7% at 2 years. There was 0% mortality, endoleaks, buttock claudication of the side treated, erectile dysfunction, and pelvic ischaemia. There were 2 cases of contralateral buttock claudication, one of contralateral iliac artery thrombosis, resolved through a femoro-femoral bypass, and one case of intra-operative IBD thrombosis that was treated favourably with thrombolysis. Mean follow-up was 23.3 months (range 1-67) with 2 losses in the study. ConclusionIn our experience, IBD is a safe and efficient technique, with few complications and good patency. Longer follow-up studies should be performed.