Thorac Cardiovasc Surg 2019; 67(S 01): S1-S100
DOI: 10.1055/s-0039-1678932
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Tuesday, February 19, 2019
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Georg Thieme Verlag KG Stuttgart · New York

Single-Center 10-Year Experience with Iliac Branch Device for the Treatment of Iliac Aneurysms

D. Branzan
1   Department of Vascular Surgery, University of Leipzig, Leipzig, Germany
,
M. Haensig
1   Department of Vascular Surgery, University of Leipzig, Leipzig, Germany
,
S. Steiner
2   Department of Angiology, University of Leipzig, Leipzig, Germany
,
U. Banning-Eichenseer
2   Department of Angiology, University of Leipzig, Leipzig, Germany
,
D. Scheinert
2   Department of Angiology, University of Leipzig, Leipzig, Germany
,
A. Schmidt
2   Department of Angiology, University of Leipzig, Leipzig, Germany
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Publikationsdatum:
28. Januar 2019 (online)

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Objectives: The aim of the study was to evaluate the long-term results of iliac branch devices (IBD) for treatment of common iliac artery (CIA) aneurysms in a monocentric cohort.

Methods: Between 2007 and 2017, 154 patients (mean age 71.5 ± 9.3 years, 149 men) with 182 consecutive IBD procedures performed at a single center were entered into a prospective database. Indications for implantation included isolated common iliac artery aneurysms (n = 81), common iliac artery aneurysms combined with abdominal aortic aneurysms (n = 66) and isolated internal iliac artery aneurysm (n = 7). Clinical data, aneurysm morphology, intraoperative variables, and follow-up strategies data were analyzed. Long-term results were reported according to the Kaplan–Meier method.

Results: A total of 172 Cook devices (Cook Inc., Bloomington, Indiana, United States), 8 Gore devices (Gore & Associates, Inc., Flagstaff, Arizona, United States), and two Jotec devices (Jotec GmbH, Hechingen, Germany) were implanted. The IBD was implanted isolated in 6.6% of the cases. In 12.6% of the cases, IBD was implanted due to a type Ib endoleak after an endovascular aneurysm repair. Visceral branch embolization and distal landing in the gluteal branch of the internal iliac artery was performed in 18.1% of cases. Technical success rate was 98.9%. Graft-related endoleak was seen in eight patients. No death occurred within 30 days of the procedure. After a mean follow-up of 37.3 ± 28.5 months freedom from IBD related reintervention was 94, 88, 85, and 85% at 1, 3, 5, and 10 years, respectively. Hypogastric artery patency was 97, 96, and 90% at 1, 3, and 10 years, respectively. Freedom from reintervention risk was 79, 72, 66, and 66% at 1, 3, 5, and 10 years, respectively.

Conclusion: The treatment of common iliac artery aneurysm with the iliac branched device is safe and can be performed with a high technical success rate. Secondary interventions are indicated during the first 5 years of follow-up and can be performed mostly endovascularly.