Distal internal iliac artery embolization: A procedure to avoid

Abstract

A significantly higher incidence of symptoms of pelvic ischemia occurred with more distal placement of coils for IIA embolization. Failure to control for extent of coil placement may account for the apparently conflicting results in published studies. IIA coil embolization should be performed as proximal as possible to prevent interference with pelvic collateral circulation.

Sequential Dilatation of the Superior Gluteal Artery Following Coil Embolization of the Internal Iliac Artery and Endovascular Abdominal Aneurysm Repair: A Case Report

“…6,7) In addition, the embolization site determines the frequency of buttock claudication: frequency is reported to be 13% for embolization of the IIA trunk alone, and 66.6% for simultaneous embolization of the IIA trunk and branches of the superior and inferior gluteal arteries. 8) In the present case, embolization of the IIA trunk, SGA, and inferior gluteal artery resulted in buttock claudication. To avoid interruption of blood flow from the contralateral IIA, we must embolize the IIA trunk alone (Fig.…”

Proximal occlusion of unaffected internal iliac artery versus distal occlusion of aneurysmatic internal iliac artery prior to EVAR: a comparative evaluation of efficacy and clinical outcome

“…It is also performed at our hospital, but was not investigated. Kritpracha et al 24 reported significantly higher symptoms of pelvic ischaemia occurring with more distal placement of coils for IIA embolization. We expected cases of bowel ischaemia rather in the DistEmbx group, but did not observe any case of bowel ischaemia after embolization of IIA.…”

“…Because of better anatomic conditions, we expected better clinical outcomes for ProxEmbX in patients with non-aneurysmatic IIA, like other investors did. [22][23][24] Coil embolization is the standard procedure for embolization of IIA prior to EVAR. Several studies reported high technical success rates.…”

Clinical Practice Guidelines for Endovascular Abdominal Aortic Aneurysm Repair: Written by the Standards of Practice Committee for the Society of Interventional Radiology and Endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Interventional Radiology Association

“…IIA revascularization by surgical bypass (94) or endovascular branched grafts are possible solutions to the potential problems associated with embolization, but add procedural complexity and possible additional complications. Additionally, a significant association between the position of embolization coils in the IIA and the development of ischemic symptoms has been suggested, prompting many investigators (95,96) to perform very proximal embolization and thus preserve collateral flow from the contralateral IIA and ipsilateral external iliac artery. Materials used for embolization include coils and nitinol plugs (eg, Amplatzer vascular plug; AGA Medical, Golden Valley, Minnesota).…”