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Clinical Outcomes of Internal Iliac Artery Interruption during Endovascular Aneurysm Repair

PURPOSE: This study aimed to investigate the clinical outcomes of internal iliac artery (IIA) interruption during endovascular aneurysm repair (EVAR) and to identify the risk factors for ischemic complications. MATERIALS AND METHODS: Endovascular treatment was performed in 316 patients with aneurysm...

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Autores principales: Kim, Hyeon Ju, Hwang, Deokbi, Kim, Hyung-Kee, Huh, Seung, Yun, Woo-Sung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Vascular Surgery 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10359766/
https://www.ncbi.nlm.nih.gov/pubmed/37475562
http://dx.doi.org/10.5758/vsi.230032
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author Kim, Hyeon Ju
Hwang, Deokbi
Kim, Hyung-Kee
Huh, Seung
Yun, Woo-Sung
author_facet Kim, Hyeon Ju
Hwang, Deokbi
Kim, Hyung-Kee
Huh, Seung
Yun, Woo-Sung
author_sort Kim, Hyeon Ju
collection PubMed
description PURPOSE: This study aimed to investigate the clinical outcomes of internal iliac artery (IIA) interruption during endovascular aneurysm repair (EVAR) and to identify the risk factors for ischemic complications. MATERIALS AND METHODS: Endovascular treatment was performed in 316 patients with aneurysms or pseudoaneurysms of the abdominal aorta or iliac arteries between March 2006 and January 2022. Medical records and radiological imaging studies were retrospectively reviewed. The incidences of buttock claudication, ischemic colitis, and spinal cord ischemia after IIA interruption were investigated as clinical outcomes. Binary logistic regression analysis were performed to identify the risk factors. RESULTS: IIA embolization was performed in 78 patients. Among the 42 patients who underwent IIA flow preservation procedures, the one-month computed tomography detected early failure in five patients. The origin of the IIA was covered with an endograft in ten patients who did not undergo embolization. Eventually, interruption of the IIA by EVAR was observed in 93 patients. Considering preoperative IIA occlusion, there was a total of six patients who did not have at least one IIA patency. Buttock claudication occurred in 32.6% of the patients, and none of the patients had ischemic colitis or spinal cord ischemia. In multivariable analysis, age ≤80 years and isolated iliac artery aneurysm were associated with the development of postoperative buttock claudication. CONCLUSION: The most common complication after IIA interruption is buttock claudication; however, critical complications such as ischemic colitis or spinal cord ischemia are rare, even in bilateral IIA occlusion. Adjunctive procedures to preserve bilateral IIA perfusion should be adopted selectively.
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spelling pubmed-103597662023-07-22 Clinical Outcomes of Internal Iliac Artery Interruption during Endovascular Aneurysm Repair Kim, Hyeon Ju Hwang, Deokbi Kim, Hyung-Kee Huh, Seung Yun, Woo-Sung Vasc Specialist Int Original Article PURPOSE: This study aimed to investigate the clinical outcomes of internal iliac artery (IIA) interruption during endovascular aneurysm repair (EVAR) and to identify the risk factors for ischemic complications. MATERIALS AND METHODS: Endovascular treatment was performed in 316 patients with aneurysms or pseudoaneurysms of the abdominal aorta or iliac arteries between March 2006 and January 2022. Medical records and radiological imaging studies were retrospectively reviewed. The incidences of buttock claudication, ischemic colitis, and spinal cord ischemia after IIA interruption were investigated as clinical outcomes. Binary logistic regression analysis were performed to identify the risk factors. RESULTS: IIA embolization was performed in 78 patients. Among the 42 patients who underwent IIA flow preservation procedures, the one-month computed tomography detected early failure in five patients. The origin of the IIA was covered with an endograft in ten patients who did not undergo embolization. Eventually, interruption of the IIA by EVAR was observed in 93 patients. Considering preoperative IIA occlusion, there was a total of six patients who did not have at least one IIA patency. Buttock claudication occurred in 32.6% of the patients, and none of the patients had ischemic colitis or spinal cord ischemia. In multivariable analysis, age ≤80 years and isolated iliac artery aneurysm were associated with the development of postoperative buttock claudication. CONCLUSION: The most common complication after IIA interruption is buttock claudication; however, critical complications such as ischemic colitis or spinal cord ischemia are rare, even in bilateral IIA occlusion. Adjunctive procedures to preserve bilateral IIA perfusion should be adopted selectively. The Korean Society for Vascular Surgery 2023-07-21 /pmc/articles/PMC10359766/ /pubmed/37475562 http://dx.doi.org/10.5758/vsi.230032 Text en Copyright © 2023, The Korean Society for Vascular Surgery https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Hyeon Ju
Hwang, Deokbi
Kim, Hyung-Kee
Huh, Seung
Yun, Woo-Sung
Clinical Outcomes of Internal Iliac Artery Interruption during Endovascular Aneurysm Repair
title Clinical Outcomes of Internal Iliac Artery Interruption during Endovascular Aneurysm Repair
title_full Clinical Outcomes of Internal Iliac Artery Interruption during Endovascular Aneurysm Repair
title_fullStr Clinical Outcomes of Internal Iliac Artery Interruption during Endovascular Aneurysm Repair
title_full_unstemmed Clinical Outcomes of Internal Iliac Artery Interruption during Endovascular Aneurysm Repair
title_short Clinical Outcomes of Internal Iliac Artery Interruption during Endovascular Aneurysm Repair
title_sort clinical outcomes of internal iliac artery interruption during endovascular aneurysm repair
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10359766/
https://www.ncbi.nlm.nih.gov/pubmed/37475562
http://dx.doi.org/10.5758/vsi.230032
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