Background
Understanding common iliac arteries (CIA) are shorter in Asian patients, we investigated whether this anatomical difference affects clinical outcomes of internal iliac artery (IIA) exclusion during endovascular repair (EVAR) of aorto-iliac aneurysm and limits the use of IIA preserving devices in Japanese patients.
Methods and Results
From 2008–2014, 69 Japanese patients underwent EVAR of aorto-iliac aneurysms with 53 unilateral and 16 bilateral IIA exclusion. One patient had persistent-buttock claudication during follow-up; however colonic or spinal cord ischemia was not observed. Anatomic suitability was investigated for the iliac branch device (IBD) by Cook Medical and iliac branch endoprosthesis (IBE) by WL Gore. Eighty-seven aorto-iliac segments were analyzed: 17% meet criteria for the IBD and 25% meet criteria for the IBE with 40% meeting criteria for either. Main exclusions for the IBD were IIA diameter >9 mm or <6 mm, (47%) and CIA length <50 mm, (39%). Main exclusions for the IBE were proximal CIA diameter <17 mm, (44%) and aorto-iliac length <165 mm, (24%).
Conclusions
EVAR with IIA exclusions in Japanese patients showed low incidence of persistent-buttock claudication and no major pelvic complications. Aorto-iliac morphology demonstrated smaller proximal CIA diameters and shorter CIA lengths, limiting the use of IIA preserving devices.