Endovascular treatment with iliac branch devices: multicenter study

Introduction: it is estimated that between 18 39 % of patients with aorto-iliac aneurysms undergoing endovascular treatment have a no suitable zone for distal sealing in common iliac arteries. Traditionally, one of the options is to perform distal seal at the external iliac arteries occluding the hy...

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Autores: Granja, JIC, Estevez, DV, Rodriguez, PG, Pineda, EP, Perello, IM, Garcia, JMZ, Melendez, SM, Palones, FG
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p10910
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/10910
Access Level:acceso abierto
Palabra clave:Aortic aneurysm
Iliac aneurysm
Endovascular technique
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spelling Endovascular treatment with iliac branch devices: multicenter studyGranja, JICEstevez, DVRodriguez, PGPineda, EPPerello, IMGarcia, JMZMelendez, SMPalones, FGAortic aneurysmIliac aneurysmEndovascular techniqueIntroduction: it is estimated that between 18 39 % of patients with aorto-iliac aneurysms undergoing endovascular treatment have a no suitable zone for distal sealing in common iliac arteries. Traditionally, one of the options is to perform distal seal at the external iliac arteries occluding the hypogastric arteries. However, this can lead to complications derived from pelvic ischemia in 28-55 % of cases. The use of iliac branched devices (IBD) allow to maintain the antegrade flow to the hypogastric arteries, avoiding these complications. the objective of our study is to analyze the medium-term results of endovascular exclusion of aorto-iliac aneurysms using IBD. Methods: a descriptive multicenter retrospetive study including the IBD for the endovascular treatment of aneurysms with involvement of the aor to iliac sector was conducted between January 2008 and July 2019. Demographic, anatomical, intra-perioperative and follow-up data was collected at 3 centers. The variables of interest analyzed were: technical success, perioperative mortality, incidence of pelvic ischemia, primary patency of the hypogastric branch and external iliac branch, DRI-related reoperation, and aneurysm-related mortality. Results: eighty IBDs were included from 61 patients: 28 (35 %) Gore (R) Excluder (R) Iliac Branch Endoprosthesis, and 52 (65 %) Cook (R) Zenith (R) Branch Endovascular Graft. Bilateral IBDs were implanted in 18 cases (29.5 %). The technical success was achieved in 95 % of cases, with no perioperative deaths. The mean follow-up was 30.1 (+/- 26.3) months. 6 patients presented pelvic ischemia during follow-up. The patency of the hypogastric side branch was 97.5 %, 94.5 %, and 90.6%, at 6, 12, and 24 months, respectively. the patency of the external iliac side branch was 100 %, 97.3 %, and 95.5 %, at 6, 12, 24 months, respectively. Freedom from reintervention rate secondary to IBD was 100 %, 96.8 %, and 94.7 %, at 6, 12, and 24 months, respectively. There was 1 case of aneurysm-related death during follow-up. Conclusions: in our experience, IBDs show good medium-term results in endovascular treatment of aorto-iliac aneurysms.These devices allow to maintain the perfusion of the hypogastric arteries, minimizing the incidence of pelvic ischemia. Although the appearance of late complications and the need for reinterventions is low, a long-term follow-up should be carried out to maintain the success of the procedure.ARAN EDICIONES, S A2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/10910AngiologiaISSN: 00033170ISSNe: 16952987reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Españolinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p109102026-06-11T12:45:17Z
dc.title.none.fl_str_mv Endovascular treatment with iliac branch devices: multicenter study
title Endovascular treatment with iliac branch devices: multicenter study
spellingShingle Endovascular treatment with iliac branch devices: multicenter study
Granja, JIC
Aortic aneurysm
Iliac aneurysm
Endovascular technique
title_short Endovascular treatment with iliac branch devices: multicenter study
title_full Endovascular treatment with iliac branch devices: multicenter study
title_fullStr Endovascular treatment with iliac branch devices: multicenter study
title_full_unstemmed Endovascular treatment with iliac branch devices: multicenter study
title_sort Endovascular treatment with iliac branch devices: multicenter study
dc.creator.none.fl_str_mv Granja, JIC
Estevez, DV
Rodriguez, PG
Pineda, EP
Perello, IM
Garcia, JMZ
Melendez, SM
Palones, FG
author Granja, JIC
author_facet Granja, JIC
Estevez, DV
Rodriguez, PG
Pineda, EP
Perello, IM
Garcia, JMZ
Melendez, SM
Palones, FG
author_role author
author2 Estevez, DV
Rodriguez, PG
Pineda, EP
Perello, IM
Garcia, JMZ
Melendez, SM
Palones, FG
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Aortic aneurysm
Iliac aneurysm
Endovascular technique
topic Aortic aneurysm
Iliac aneurysm
Endovascular technique
description Introduction: it is estimated that between 18 39 % of patients with aorto-iliac aneurysms undergoing endovascular treatment have a no suitable zone for distal sealing in common iliac arteries. Traditionally, one of the options is to perform distal seal at the external iliac arteries occluding the hypogastric arteries. However, this can lead to complications derived from pelvic ischemia in 28-55 % of cases. The use of iliac branched devices (IBD) allow to maintain the antegrade flow to the hypogastric arteries, avoiding these complications. the objective of our study is to analyze the medium-term results of endovascular exclusion of aorto-iliac aneurysms using IBD. Methods: a descriptive multicenter retrospetive study including the IBD for the endovascular treatment of aneurysms with involvement of the aor to iliac sector was conducted between January 2008 and July 2019. Demographic, anatomical, intra-perioperative and follow-up data was collected at 3 centers. The variables of interest analyzed were: technical success, perioperative mortality, incidence of pelvic ischemia, primary patency of the hypogastric branch and external iliac branch, DRI-related reoperation, and aneurysm-related mortality. Results: eighty IBDs were included from 61 patients: 28 (35 %) Gore (R) Excluder (R) Iliac Branch Endoprosthesis, and 52 (65 %) Cook (R) Zenith (R) Branch Endovascular Graft. Bilateral IBDs were implanted in 18 cases (29.5 %). The technical success was achieved in 95 % of cases, with no perioperative deaths. The mean follow-up was 30.1 (+/- 26.3) months. 6 patients presented pelvic ischemia during follow-up. The patency of the hypogastric side branch was 97.5 %, 94.5 %, and 90.6%, at 6, 12, and 24 months, respectively. the patency of the external iliac side branch was 100 %, 97.3 %, and 95.5 %, at 6, 12, 24 months, respectively. Freedom from reintervention rate secondary to IBD was 100 %, 96.8 %, and 94.7 %, at 6, 12, and 24 months, respectively. There was 1 case of aneurysm-related death during follow-up. Conclusions: in our experience, IBDs show good medium-term results in endovascular treatment of aorto-iliac aneurysms.These devices allow to maintain the perfusion of the hypogastric arteries, minimizing the incidence of pelvic ischemia. Although the appearance of late complications and the need for reinterventions is low, a long-term follow-up should be carried out to maintain the success of the procedure.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/10910
url https://fisabio.portalinvestigacion.com/publicaciones/10910
dc.language.none.fl_str_mv Español
language_invalid_str_mv Español
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ARAN EDICIONES, S A
publisher.none.fl_str_mv ARAN EDICIONES, S A
dc.source.none.fl_str_mv Angiologia
ISSN: 00033170
ISSNe: 16952987
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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