Giovanni Pratesi1, Aaron Fargion2, Raffaele Pulli2, Walter Dorigo2, Azzurra Guidotti2, Matteo Barbante1, Eleonora Centonza1, Diego Patacconi1, Martina Battistini1, Arnaldo Ippoliti1, Carlo Pratesi2
1Unit of Vascular Surgery, University of Roma Tor Vergata, Rome, Italy; 2Unit of Vascular Surgery, University of Florence, Florence, Italy.
OBJECTIVES: To analyze long-term durability of endovascular treatment (EVAR) for aorto-iliac aneurysm with the use of iliac branch device (IBD).
METHODS: A prospective analysis of all patients underwent EVAR with IBD between September 2007 and December 2012 was carried out. Main clinical, anatomical and technical data concerning pre-, intra- and post-operative period were prospectively collected into a dedicated database. Follow-up consisted of clinical examination, duplex scan and computed tomography at 1, 6, 12 months and yearly thereafter. Data were reported according to the Kaplan-Meier method.
RESULTS: Ninety-five EVAR procedures with IBD were electively carried out in 91 patients. Among the 35 (36.8%) bilateral iliac aneurysms, 4 patients (4.2%) received bilateral IBD. Technical success was obtained in 98.9% of cases. Median follow-up duration was 23.4 months (range 1-63 months). There was one IBD occlusion (1%). Estimated 60 months survival, freedom from reintervention and branch occlusion was 79.7%, 88.3% and 98.1%, respectively. Seven patients (7.3%), 6 of them treated for bilateral iliac aneurysms, developed persistent buttock claudication on the side of hypogastric exclusion whereas no pelvic ischemic symptoms were observed on the side of patent IBD.
CONCLUSIONS: EVAR for aortoiliac aneurysm using IBD is durable procedure with low complications and reinterventions rates at 5 years follow-up. Since no buttock claudication was observed in patients with patent IBD, it could be proposed as first line treatment whenever anatomically feasible.
AUTHOR DISCLOSURES: M. Barbante: Nothing to disclose; M. Battistini: Nothing to disclose; E. Centonza: Nothing to disclose; W. Dorigo: Nothing to disclose; A. Fargion: Nothing to disclose; A. Guidotti: Nothing to disclose; A. Ippoliti: Nothing to disclose; D. Patacconi: Nothing to disclose; C. Pratesi: Nothing to disclose; G. Pratesi: Nothing to disclose; R. Pulli: Nothing to disclose.
Posted April 2013