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8-Year Long-Term Outcome Comparison: Two Ways to Exclude the Internal Iliac Artery during Endovascular Aorta Repair (EVAR) Surgery.

Luo H, Huang B, Yuan D, Yang Y, Xiong F, Zeng G, Wu Z, Chen X, Du X, Wen X, Liu C, Yang H, Zhao J - PLoS ONE (2015)

Bottom Line: There were no significant differences in the early outcomes of intraoperative blood loss (87.23±14.07 ml; A: 86.53±9.57 ml vs.However, there were significant differences in contrast consumption (65.18±9.85 ml; A: 61.89±7.95 ml vs.In the follow-up analysis, no significant differences were identified in the incidence of endoleak (22 subjects; type I: A: 2 vs.

View Article: PubMed Central - PubMed

Affiliation: West China Medical School of Sichuan University, 37 Guo Xue Alley, Chengdu 610041, Sichuan Province, China.

ABSTRACT

Purpose: To evaluate the 8-year long-term outcome after internal iliac artery (IIA) coverage with or without embolization in EVAR.

Patients and methods: From January 2006 to December 2013, abdominal aortic aneurysm (AAA) subjects that underwent EVAR and IIA exclusion were recruited and analyzed retrospectively. All the subjects were divided into group A or B based on the presence or absence of intraoperative IIA embolization before coverage (group A: without embolization; group B: with embolization). The 30-day mortality, stent patency, and the incidences of endoleaks and ischemia of the buttocks and lower limbs were compared. The follow-up period was 96 months.

Result: There were 137 subjects (A: 74 vs. B: 63), 124 male (91.1%) and 13 female (9.5%), with a mean age of 71.6 years. There were no significant differences in the early outcomes of intraoperative blood loss (87.23±14.07 ml; A: 86.53±9.57 ml vs. B: 88.06±18.04 ml, p = .545) and surgery time (87.13±9.25 min; A: 85.99±7.07 min vs. B: 88.48±11.19 min, p = .130). However, there were significant differences in contrast consumption (65.18±9.85 ml; A: 61.89±7.95 ml vs. B: 69.05±10.50 ml, p<.001) and intraoperative X-ray time (5.9±0.86 min; A: 5.63±0.49 min vs. B: 6.22±1.07 min, P<.001). The 30-day mortality was approximately 0.73%. In the follow-up analysis, no significant differences were identified in the incidence of endoleak (22 subjects; type I: A: 2 vs. B: 2, p = 1.000; type II: A: 8 vs. B: 4, p = .666; type III: A: 4 vs. B: 3, p = 1.000), occlusion (5 subjects; 4.35%; A: 1 vs. B: 4, p = .180), or ischemia (9 subjects; 7.83%; A: 3 vs. B: 6, p = .301). In the analysis of group B, although there were no significant differences between subjects with unilateral and bilateral IIA embolization, but longer hospital stays were required (P<.001), and a more severe complication (skin and gluteus necrosis) occurred in 1 subject with bilateral IIA embolization.

Conclusion: IIA could be excluded during EVAR. IIA coverage without embolization had a good surgical and prognostic outcome, and this procedure was not different significantly from coverage with embolization in terms of endoleaks, patency and ischemia.

No MeSH data available.


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*n1: abdominal aortic aneurysm (AAA); n2: right common iliac artery aneurysm (CIAA); n3: left CIAA; n4: right internal iliac artery aneurysm (IIAA); and n5: left IIAA.*n1: 47; n1+2: 17; n1+3: 5; n1+4: 6; n1+5: 3; n1+2+3: 25; n1+2+5: 7; n1+2+4: 2; n1+3+4: 1; n1+3+5:1; n1+4+5: 3; n1+2+3+4: 4; n1+2+4+5: 2; n1+2+3+5: 5; and n1+2+3+4+5: 9. n1+2 represents an AAA that invaded the right common iliac artery; the others were considered likely. * Fig 2 is just an illustration; we cannot show the exact anatomical details.
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pone.0130586.g002: *n1: abdominal aortic aneurysm (AAA); n2: right common iliac artery aneurysm (CIAA); n3: left CIAA; n4: right internal iliac artery aneurysm (IIAA); and n5: left IIAA.*n1: 47; n1+2: 17; n1+3: 5; n1+4: 6; n1+5: 3; n1+2+3: 25; n1+2+5: 7; n1+2+4: 2; n1+3+4: 1; n1+3+5:1; n1+4+5: 3; n1+2+3+4: 4; n1+2+4+5: 2; n1+2+3+5: 5; and n1+2+3+4+5: 9. n1+2 represents an AAA that invaded the right common iliac artery; the others were considered likely. * Fig 2 is just an illustration; we cannot show the exact anatomical details.

Mentions: Seventy-four subjects were in group A, and 63 subjects were in group B. Among the 137 consecutive subjects, 124 (91.1%) were male, and 13 (9.5%) were female, with mean ages of 71.56 and 71.67 years, respectively. The vascular morphologic characteristics of the 137 subjects are shown in Fig 2. General patient information is provided in Table 1.


8-Year Long-Term Outcome Comparison: Two Ways to Exclude the Internal Iliac Artery during Endovascular Aorta Repair (EVAR) Surgery.

Luo H, Huang B, Yuan D, Yang Y, Xiong F, Zeng G, Wu Z, Chen X, Du X, Wen X, Liu C, Yang H, Zhao J - PLoS ONE (2015)

*n1: abdominal aortic aneurysm (AAA); n2: right common iliac artery aneurysm (CIAA); n3: left CIAA; n4: right internal iliac artery aneurysm (IIAA); and n5: left IIAA.*n1: 47; n1+2: 17; n1+3: 5; n1+4: 6; n1+5: 3; n1+2+3: 25; n1+2+5: 7; n1+2+4: 2; n1+3+4: 1; n1+3+5:1; n1+4+5: 3; n1+2+3+4: 4; n1+2+4+5: 2; n1+2+3+5: 5; and n1+2+3+4+5: 9. n1+2 represents an AAA that invaded the right common iliac artery; the others were considered likely. * Fig 2 is just an illustration; we cannot show the exact anatomical details.
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4507853&req=5

pone.0130586.g002: *n1: abdominal aortic aneurysm (AAA); n2: right common iliac artery aneurysm (CIAA); n3: left CIAA; n4: right internal iliac artery aneurysm (IIAA); and n5: left IIAA.*n1: 47; n1+2: 17; n1+3: 5; n1+4: 6; n1+5: 3; n1+2+3: 25; n1+2+5: 7; n1+2+4: 2; n1+3+4: 1; n1+3+5:1; n1+4+5: 3; n1+2+3+4: 4; n1+2+4+5: 2; n1+2+3+5: 5; and n1+2+3+4+5: 9. n1+2 represents an AAA that invaded the right common iliac artery; the others were considered likely. * Fig 2 is just an illustration; we cannot show the exact anatomical details.
Mentions: Seventy-four subjects were in group A, and 63 subjects were in group B. Among the 137 consecutive subjects, 124 (91.1%) were male, and 13 (9.5%) were female, with mean ages of 71.56 and 71.67 years, respectively. The vascular morphologic characteristics of the 137 subjects are shown in Fig 2. General patient information is provided in Table 1.

Bottom Line: There were no significant differences in the early outcomes of intraoperative blood loss (87.23±14.07 ml; A: 86.53±9.57 ml vs.However, there were significant differences in contrast consumption (65.18±9.85 ml; A: 61.89±7.95 ml vs.In the follow-up analysis, no significant differences were identified in the incidence of endoleak (22 subjects; type I: A: 2 vs.

View Article: PubMed Central - PubMed

Affiliation: West China Medical School of Sichuan University, 37 Guo Xue Alley, Chengdu 610041, Sichuan Province, China.

ABSTRACT

Purpose: To evaluate the 8-year long-term outcome after internal iliac artery (IIA) coverage with or without embolization in EVAR.

Patients and methods: From January 2006 to December 2013, abdominal aortic aneurysm (AAA) subjects that underwent EVAR and IIA exclusion were recruited and analyzed retrospectively. All the subjects were divided into group A or B based on the presence or absence of intraoperative IIA embolization before coverage (group A: without embolization; group B: with embolization). The 30-day mortality, stent patency, and the incidences of endoleaks and ischemia of the buttocks and lower limbs were compared. The follow-up period was 96 months.

Result: There were 137 subjects (A: 74 vs. B: 63), 124 male (91.1%) and 13 female (9.5%), with a mean age of 71.6 years. There were no significant differences in the early outcomes of intraoperative blood loss (87.23±14.07 ml; A: 86.53±9.57 ml vs. B: 88.06±18.04 ml, p = .545) and surgery time (87.13±9.25 min; A: 85.99±7.07 min vs. B: 88.48±11.19 min, p = .130). However, there were significant differences in contrast consumption (65.18±9.85 ml; A: 61.89±7.95 ml vs. B: 69.05±10.50 ml, p<.001) and intraoperative X-ray time (5.9±0.86 min; A: 5.63±0.49 min vs. B: 6.22±1.07 min, P<.001). The 30-day mortality was approximately 0.73%. In the follow-up analysis, no significant differences were identified in the incidence of endoleak (22 subjects; type I: A: 2 vs. B: 2, p = 1.000; type II: A: 8 vs. B: 4, p = .666; type III: A: 4 vs. B: 3, p = 1.000), occlusion (5 subjects; 4.35%; A: 1 vs. B: 4, p = .180), or ischemia (9 subjects; 7.83%; A: 3 vs. B: 6, p = .301). In the analysis of group B, although there were no significant differences between subjects with unilateral and bilateral IIA embolization, but longer hospital stays were required (P<.001), and a more severe complication (skin and gluteus necrosis) occurred in 1 subject with bilateral IIA embolization.

Conclusion: IIA could be excluded during EVAR. IIA coverage without embolization had a good surgical and prognostic outcome, and this procedure was not different significantly from coverage with embolization in terms of endoleaks, patency and ischemia.

No MeSH data available.


Related in: MedlinePlus