Results of the multicenter pELVIS Registry for isolated common iliac aneurysms treated by the iliac branch device

Fargion, Aaron; Masciello, Fabrizio; Pratesi, Carlo; Pratesi, Giovanni; Torsello, Giovanni; Donas, Konstantinos P.; Austermann, Martin; Weiss, Kristin; Bosiers, Michel; Dorigo, Walter; Cao, Piergiorgio; Ferrer, Ciro; Ippoliti, Arnaldo; Barbante, Matteo; Pitoulias, Georgios A.; Verzini, Fabio; Parlani, Gianbattista; Simonte, Gioele; Kölbel, Tilo; Tsilimparis, Nikolaos; Haulon, Stéphan; Branzan, Daniela; Schmidt, Andrej

doi:10.1016/j.jvs.2018.02.032

Cited by 40 publications

(28 citation statements)

References 26 publications

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“…Fargion et al used the 12 year European experience from the pELVIS registry to publish the largest reported IBD series in the literature. 4 They confirmed the safety and feasibility of IBDs in high surgical risk patients by its low mortality and complication rate. The only other IBD outcome series in the literature are single centre retrospective cohort studies of smaller sample size.…”

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confidence: 69%

Iliac Branch Devices in Women: Results From the pELVIS Registry

Soler

Charbonneau

Sobocinski

et al. 2020

European Journal of Vascular and Endovascular Surgery

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RegistryIliac branch device (IBD) technology has become a more accepted endovascular option to preserve internal iliac artery flow for aneurysms involving the iliac bifurcation.Because several studies reported inferior outcomes in women compared with men after endovascular aortic aneurysm repair with standard EVAR devices, 1 the aim of this work was to evaluate the impact of sex differences on the post-operative outcome for patients treated with an IBD.A retrospective review was performed using the pELVIS registry, in which nine high volume European centres are participating. An IBD was indicated as the preferable first line endovascular treatment for a >24 mm diameter aneurysm involving the iliac bifurcation as suggested by Verzini et al. 2 All patients were deemed to be high risk for an open surgical procedure, defined by the presence of three or more serious predetermined cardiovascular comorbidities. Details regarding other inclusion criteria, data collection, and follow up imaging have been published previously. 3 This registry provided longitudinal postoperative outcomes for up to 60 months. This project was approved by the local ethics committee.Between 2005 and 2017, 804 (mean age 72.1 AE 8.6 years) consecutives patients were treated with 910 IBDs. There were 36 women (4.5%) and 768 men (95.5%) and no differences were found between the two groups when comparing for age, aneurysm morphology, and preoperative risk factors. On completion angiography, 21 (2.6%) patients had a type 1 endoleak, and they were all men. No intra-operative conversion or deaths occurred.No difference in 30 day mortality between women and men (2.8% vs. 0.4%, p ¼ .17) was found. The deaths were secondary to myocardial infarction in two cases, respiratory failure combined with stroke in one case, and acute renal failure in the last case. Median hospital length of stay was 7 (range 5e9) days with no sex differences. Moreover, there was no significant difference between women and men in the rates of 30 day complication, myocardial infarction, stroke, pneumonia, peripheral embolisation, early graft thrombosis, colonic ischaemia, and 30 day re-intervention (Table 1). Acute renal failure requiring dialysis appeared to be higher in the women cohort (5.6% vs. 0.7%, p ¼ .036).Over a median follow up of 21.1 (range 8.9e43.9) months, there were no sex related differences for endoleaks, ipsilateral iliac artery occlusion, bridging stent late occlusion, stent migration, re-intervention, or pelvis ischaemia. The aneurysm related mortality (ARM) was significantly higher in women than in men (5.6% vs. 0.7%, p ¼ .036), with all those deaths occurring within 30 days of the index procedure or a re-intervention.

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confidence: 69%

Iliac Branch Devices in Women: Results From the pELVIS Registry

Soler

Charbonneau

Sobocinski

et al. 2020

European Journal of Vascular and Endovascular Surgery

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“…62e66 Adjunctive maneuvers (such as brachial access, 67,68 use of a steerable sheath, 69,70 or an up-and-over technique 71 ) can be used to deliver the IIA components in selected situations and, when anatomy permits, an isolated IBD can be used for isolated iliac aneurysmal disease. 72,73 Thus, there will likely be an increasing number of patients treated with IBDs in real-world settings. 74…”

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confidence: 99%

Perioperative Outcomes After Use of Iliac Branch Devices Compared With Hypogastric Occlusion or Open Surgery for Elective Treatment of Aortoiliac Aneurysms in the NSQIP Database

D’Oria

Mendes

Bews

et al. 2020

Annals of Vascular Surgery

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“…Patency rates are high, ranging from 86% to 93%. Reintervention remains an issue with a reported range between 4% and 22%, mostly related to endoleak 9, 10, 11. Whereas a stented vessel is a component of this technique, the risk of endoleak is essentially eliminated by opening the aneurysm sac and managing any side branches by surgical ligation as well as tacking the stent in place in the IIA.…”

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confidence: 99%

Total robotic iliac aneurysm repair with preservation of the internal iliac artery using sutureless vascular anastomosis

Colvard

Georg

Lejay

et al. 2019

Journal of Vascular Surgery Cases, Innovations and Techniques

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Objective Internal iliac artery (IIA) preservation is associated with improved outcomes after both open and endovascular aortoiliac aneurysm repair. Total robotic laparoscopic repair of aortoiliac aneurysms has been reported in the past, but not in combination with sutureless anastomosis applied to the IIAs. The objective of this study was to demonstrate the feasibility of the total robotic laparoscopic technique including a method of deploying the Gore Hybrid Vascular Graft (GHVG; W. L. Gore & Associates, Flagstaff, Ariz) using robotic instruments. Methods Between June 2015 and December 2016, four patients underwent total robotic laparoscopic repair of isolated common iliac artery (CIA) aneurysms. Two patients had unilateral aneurysms and two had bilateral aneurysms. Unilateral CIA aneurysms were treated with a graft from the proximal CIA to the proximal external iliac artery, and bilateral CIA aneurysms were treated with a bifurcated graft between the distal aorta and both proximal external iliac arteries. The nitinol reinforced section of the GHVG was then inserted and deployed into the corresponding IIA, and the nonreinforced segment was sewn in an end-to-side fashion to the iliac graft. Results The median age of patients was 55.5 years (range, 48-64 years); median body mass index was 24.9 kg/m 2 (range, 23-26.4 kg/m 2 ). All four cases were technically successful. Operative times were 325 and 332 minutes for unilateral cases and 491 and 385 minutes for bilateral cases. For the entire series, median proximal clamping time was 143 minutes (range, 110-163 minutes), and the median time to deploy the GHVG was 15 minutes (range, 8-27 minutes). The median estimated blood loss was 1800 mL (range, 800-2100 mL). Intraoperative cell salvage was used in all cases. No intraoperative or postoperative complications occurred. No patient required blood transfusion. All patients tolerated a regular diet on postoperative day 2 and were discharged on postoperative day 4. Patients returned to work and full physical activity within 6 weeks (range, 2-6 weeks). At 6-month follow-up, computed tomography angiography demonstrated 100% patency of iliac artery grafts as well as of the GHVGs. Conclusions Total robotic laparoscopic CIA aneurysm repair is feasible in both unilateral and bilateral cases in carefully selected patients. The GHVG can be successfully deployed using robotic technique for IIA preservation during total robotic CIA aneurysm repair.

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Results of the multicenter pELVIS Registry for isolated common iliac aneurysms treated by the iliac branch device

Cited by 40 publications

References 26 publications

Iliac Branch Devices in Women: Results From the pELVIS Registry

Iliac Branch Devices in Women: Results From the pELVIS Registry

Perioperative Outcomes After Use of Iliac Branch Devices Compared With Hypogastric Occlusion or Open Surgery for Elective Treatment of Aortoiliac Aneurysms in the NSQIP Database

Total robotic iliac aneurysm repair with preservation of the internal iliac artery using sutureless vascular anastomosis

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