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Outcomes of Extended Endovascular Aortic Repair for Aorto-Iliac Aneurysm with Internal Iliac Artery Occlusion.
Ann Vasc Dis. 2017 Dec 25; 10(4):359-363.AV

Abstract

Objective:

Patients of aorto-iliac aneurysms who undergo endovascular aortic repair (EVAR) require internal iliac artery (IIA) occlusion with coil embolization and its coverage with the stent graft to prevent type II endoleak after extending the endograft into the external iliac artery. However, it has become well recognized that IIA occlusion cause buttock claudication and other various sequelae due to pelvic ischemia. We retrospectively analyzed IIA occlusion outcomes.

Methods:

From October 2008 to February 2015, 71 patients with aorto-iliac aneurysms underwent IIA occlusion prior to EVAR. The relationship between pelvic circulation and symptom of pelvic ischemia was studied.

Results:

Buttock claudication occurred in 17 patients (22.9%) of all. Eight patients (14.8%) in unilateral IIA occlusion group (54 patients) and nine patients (52.9%) in bilateral IIA group (17 patients) had sequelae of claudication. The sacrifice of the communication of superior gluteal artery (SGA) and inferior gluteal artery (IGA) led to buttock claudication in 18 (64.3%) of 28 limbs. Instead, only 4 of 60 limbs had buttock claudication, when we preserved the communication between SGA and IGA. In all patients, staged treatment of aorto-iliac aneurysms with IIA occlusion and EVAR were done successfully without pelvic ischemic complications except for buttock claudication, and postoperative CT scanning showed no endoleakage.

Conclusion:

IIA occlusion prior to EVAR is recognized as a safe and reasonable strategy. It is emphasized that preservation of the communication of SGA and IGA is important to prevent buttock claudication. (This is a translation of Jpn J Vasc Surg 2016; 25: 240-245.).

Authors+Show Affiliations

Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan.Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan.Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan.Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan.Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan.Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan.Department of Cardiovascular Surgery, National Center for Global Health and Medicine, Tokyo, Japan.Department of Cardiovascular Surgery, Shimada General Hospital, Choshi, Chiba, Japan.Department of Cardiovascular Surgery, Shimada General Hospital, Choshi, Chiba, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29515696

Citation

Fujioka, Shunichiro, et al. "Outcomes of Extended Endovascular Aortic Repair for Aorto-Iliac Aneurysm With Internal Iliac Artery Occlusion." Annals of Vascular Diseases, vol. 10, no. 4, 2017, pp. 359-363.
Fujioka S, Hosaka S, Morimura H, et al. Outcomes of Extended Endovascular Aortic Repair for Aorto-Iliac Aneurysm with Internal Iliac Artery Occlusion. Ann Vasc Dis. 2017;10(4):359-363.
Fujioka, S., Hosaka, S., Morimura, H., Chen, K., Wang, Z. C., Toguchi, K., Fukuda, S., Takizawa, K., & Osawa, H. (2017). Outcomes of Extended Endovascular Aortic Repair for Aorto-Iliac Aneurysm with Internal Iliac Artery Occlusion. Annals of Vascular Diseases, 10(4), 359-363. https://doi.org/10.3400/avd.oa.17-00089
Fujioka S, et al. Outcomes of Extended Endovascular Aortic Repair for Aorto-Iliac Aneurysm With Internal Iliac Artery Occlusion. Ann Vasc Dis. 2017 Dec 25;10(4):359-363. PubMed PMID: 29515696.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of Extended Endovascular Aortic Repair for Aorto-Iliac Aneurysm with Internal Iliac Artery Occlusion. AU - Fujioka,Shunichiro, AU - Hosaka,Shigeru, AU - Morimura,Hayato, AU - Chen,Ken, AU - Wang,Zhi Chao, AU - Toguchi,Koji, AU - Fukuda,Shoji, AU - Takizawa,Koki, AU - Osawa,Hiroshi, PY - 2018/3/9/entrez PY - 2018/3/9/pubmed PY - 2018/3/9/medline KW - buttock claudication KW - endovascular aortic repair KW - iliac artery coil embolization SP - 359 EP - 363 JF - Annals of vascular diseases JO - Ann Vasc Dis VL - 10 IS - 4 N2 - Objective: Patients of aorto-iliac aneurysms who undergo endovascular aortic repair (EVAR) require internal iliac artery (IIA) occlusion with coil embolization and its coverage with the stent graft to prevent type II endoleak after extending the endograft into the external iliac artery. However, it has become well recognized that IIA occlusion cause buttock claudication and other various sequelae due to pelvic ischemia. We retrospectively analyzed IIA occlusion outcomes. Methods: From October 2008 to February 2015, 71 patients with aorto-iliac aneurysms underwent IIA occlusion prior to EVAR. The relationship between pelvic circulation and symptom of pelvic ischemia was studied. Results: Buttock claudication occurred in 17 patients (22.9%) of all. Eight patients (14.8%) in unilateral IIA occlusion group (54 patients) and nine patients (52.9%) in bilateral IIA group (17 patients) had sequelae of claudication. The sacrifice of the communication of superior gluteal artery (SGA) and inferior gluteal artery (IGA) led to buttock claudication in 18 (64.3%) of 28 limbs. Instead, only 4 of 60 limbs had buttock claudication, when we preserved the communication between SGA and IGA. In all patients, staged treatment of aorto-iliac aneurysms with IIA occlusion and EVAR were done successfully without pelvic ischemic complications except for buttock claudication, and postoperative CT scanning showed no endoleakage. Conclusion: IIA occlusion prior to EVAR is recognized as a safe and reasonable strategy. It is emphasized that preservation of the communication of SGA and IGA is important to prevent buttock claudication. (This is a translation of Jpn J Vasc Surg 2016; 25: 240-245.). SN - 1881-641X UR - https://www.unboundmedicine.com/medline/citation/29515696/Outcomes_of_Extended_Endovascular_Aortic_Repair_for_Aorto_Iliac_Aneurysm_with_Internal_Iliac_Artery_Occlusion_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/29515696/ DB - PRIME DP - Unbound Medicine ER -
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