Anatomic Suitability of Iliac Branched Devices for Chinese Patients with Abdominal-Iliac Aortic Aneurysm

Muzepper, Mehmutjan; Zhou, Min

doi:10.1016/j.avsg.2020.03.010

Cited by 11 publications

(9 citation statements)

References 21 publications

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“…Currently, the major anatomic limitation of IBD in East Asians is the unsuitability of the IIA diameter for the placement of bridging stent grafts. In studies involving Asian patients, a reported 9.8% of Chinese and 17.0% of Japanese patients are anatomically suitable according to the basic ZBIS IFU [ 13 , 14 ]. Among the reasons for anatomic exclusion for basic ZBIS IFU, the most common was an IIA diameter of <6 mm or >9 mm.…”

Section: Discussionmentioning

confidence: 99%

“…Among the reasons for anatomic exclusion for basic ZBIS IFU, the most common was an IIA diameter of <6 mm or >9 mm. Accordingly, 78% of Chinese and 47% of Japanese patients were excluded from the basic IFU [ 13 , 14 ]. Thus, for the successful placement of IBD in Korean patients, a further analysis of the anatomy of aortoiliac aneurysms and isolated CIAA among Korean patients is required along with the introduction of an additional usable device, research, and follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Type Ic Endoleak after LifeStream Balloon-Expandable Stent Graft and Zenith Iliac Branch Device Placement

Kim

Yun

Kim

2023

Vasc Specialist Int

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Considering the recent advancements in endovascular management of aortoiliac aneurysms, the use of an iliac branch device (IBD) to preserve pelvic blood flow and reduce complications caused by embolization of the internal iliac artery (IIA) is recommended by various guidelines. Although the outcomes reported following IBD placement are mainly positive and durable, IBD-specific complications such as a type Ic endoleak and associated reintervention may occur. Moreover, only one IBD device and one type of balloon-expandable bridging stent graft for IIA are currently available on the domestic market. Here we present two cases of type Ic endoleak following IBD placement. In both cases, IIA diameter was slightly larger than the basic instructions for use. Notably, the initial procedures were considered successful; however, type Ic endoleaks were detected on 1-month follow-up imaging. This finding emphasizes the need for a precise preoperative evaluation, intraoperative manipulation, and postoperative follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Type Ic Endoleak after LifeStream Balloon-Expandable Stent Graft and Zenith Iliac Branch Device Placement

Kim

Yun

Kim

2023

Vasc Specialist Int

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“…However, the usage of IBDs is limited by anatomical characteristics. Several published literature have analyzed the applicability of Cook and Gore device for AAA patients requiring extension into EIA during EVAR ( 4 , 5 ). Itoga et al demonstrated that the anatomic suitability of Japanese patients with aortoiliac aneurysm for those two IBDs was limited by smaller CIA diameter and shorter CIA length ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the complex anatomical characteristics of the CIAA pose a challenge for device implantation, distal anchoring, and complete aneurysm exclusion. There is evidence indicating that not all patients fit the instructions for use (IFUs) of standard bifurcated endografts (4). A common approach is to extend the limb directly into the external iliac artery (EIA), with or without concomitant internal iliac artery (IIA) embolization (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

“…Among those, Lifetech iliac branch stent graft (IBSG) is the only device obtained the China National Medical Products Administration (NMPA) approval. Anatomical characteristics of aortoiliac aneurysm (AIA) have been regarded as a major factor affecting the application of IBDs ( 4 , 5 ). Therefore, in this study, four types of IBDs were assessed for their suitability of Eastern Asian patients with AIA according to their instruction for use (IFU).…”

Section: Introductionmentioning

confidence: 99%

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A Multicenter Assessment of Anatomic Suitability for Iliac Branched Devices in Eastern Asian Patients With Unilateral and Bilateral Aortoiliac Aneurysms

Zhou

Wang

et al. 2022

Front. Cardiovasc. Med.

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Objective: This study aims to assess the suitability of four types of commercial iliac branch device systems to treat Eastern Asian abdominal aortic aneurysm (AAA) patients with bilateral or unilateral common iliac artery aneurysms (CIAAs).Methods: Patients with a coexisting AAA and a unilateral or bilateral CIAAs who underwent endovascular aneurysm repair (EVAR) at two tertiary centers in China from 2015 to 2017 were reviewed. Morphology of lesions was measured and the anatomic suitability for Cook iliac branch device (IBD), Gore iliac branch endoprosthesis (IBE), Lifetech iliac branch stent graft (IBSG), and Jotec IBD was evaluated according to the latest instructions for use.Results: Seventy-six patients with AAA were enrolled, including 35 bilateral CIAAs, 41 unilateral CIAAs. A hundred and eleven lesions were investigated aggregately: 16.2, 28.8, 21.6, and 19.8% met the criteria for Cook IBD, Gore IBE, Lifetech IBSG, and Jotec IBD, respectively. A total of 34 (44.7%) patients could be treated for at least one lateral lesion. The diameter of the internal iliac artery (IIA) was the most common restriction for IBD application. Additionally, the IIA diameter of lesions in the bilateral group was significantly larger compared with the unilateral group (P < 0.001). Based on the anatomical characteristics alone, it is likely that IBDs will be more suitable for unilateral lesions than bilateral ones (P < 0.05). However, there was no difference between the suitability for patients with unilateral or bilateral CIAAs (P > 0.05).Conclusions: Less than half of Eastern Asian patients with aortoiliac aneurysms were eligible for IBD application. This was primarily due to the IIA diameter failing to meet the criteria. And thus, the suitability of lesions in bilateral group was significantly lower than that in the unilateral group. Aiming to expand the indications and optimize the design of the iliac branch devices, IIA diameter and the anatomical characteristics of the bilateral lesions should be considered deliberately.

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Multicenter CT Image-Based Anatomic Assessment of Patients with Aortoiliac Aneurysm Undergoing Endovascular Repair with Iliac Branch Devices

Panthofer,

Bresler,

Olson

et al. 2024

Annals of Vascular Surgery

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Anatomic Suitability of Iliac Branched Devices for Chinese Patients with Abdominal-Iliac Aortic Aneurysm

Cited by 11 publications

References 21 publications

Type Ic Endoleak after LifeStream Balloon-Expandable Stent Graft and Zenith Iliac Branch Device Placement

Type Ic Endoleak after LifeStream Balloon-Expandable Stent Graft and Zenith Iliac Branch Device Placement

A Multicenter Assessment of Anatomic Suitability for Iliac Branched Devices in Eastern Asian Patients With Unilateral and Bilateral Aortoiliac Aneurysms

Multicenter CT Image-Based Anatomic Assessment of Patients with Aortoiliac Aneurysm Undergoing Endovascular Repair with Iliac Branch Devices

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