Internal iliac coverage during endovascular repair of abdominal aortic aneurysms is a safe option: A preliminary study

Abstract

Endovascular aneurysm repairs lacking suitable common iliac artery landing zones occasionally require graft limb extension into the external iliac artery, covering the internal iliac artery origin. The purpose of this study was to assess incidence of type II endoleak following simple coverage of internal iliac artery without embolization during endovascular aneurysm repair. Three hundred eighty-nine endovascular aneurysm repairs performed by a single surgeon (2004-2015) were reviewed. Twenty-seven patients underwent simple internal iliac artery coverage. Type II endoleak was assessed from operative reports and follow-up computed tomography imaging. No patient suffered type II endoleak from a covered internal iliac artery in post-operative computed tomography scans. Follow-up ranged from 0.5 to 9 years. No severe pelvic ischemic complications were observed. In conclusion, for selected cases internal iliac artery coverage without embolization is a safe alternative to embolization in endovascular aneurysm repairs, where the graft must be extended into the external iliac artery.

Aorto-Uni-Iliac Stent Grafting and Femoro-Femoral Bypass in a Patient with a Failed and Catastrophic Endovascular Aortic Aneurysm Repair

“…Recent reports suggest that not all patients require IIA embolization, as IIA coverage solely by the stent graft without embolization is not associated with a significant higher rate of type II endoleak for selected cases [ 6 – 8 ]. In their reports, the acceptable criteria for covering the IIA without embolization was the presence of the IIA with a diameter of less than 5 mm, which was smaller than that of our patient.…”