Therapeutic management of isolated internal iliac artery aneurysms

Yang, Meng; Li, Lecong; Liu, Yang; Su, Qingbo; Dong, Zhao‐Ru; Li, Guangzhen; Jiang, Jianjun; Ding, Xiangjiu

doi:10.1016/j.jvs.2020.02.038

Cited by 8 publications

(24 citation statements)

References 18 publications

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“…Two studies arose from a multicenter experience (2 centers for each paper). 11,14 One paper presented 2 different groups of patients, both eligible for inclusion, as separate data; thus, we considered these 2 groups as separate series during meta-analysis. 21 NO score range was 5–6, with median of 6 (Supplementary Table I).…”

Section: Resultsmentioning

confidence: 99%

“…The most commonly performed treatment was endovascular repair; in fact, only 2 articles reported open surgical treatment upon 21/202 cases. 11,21 Open repair included 16/21 surgical resections or aneurysmorraphy, 4/21 proximal ligations, and 1/21 distal revascularizations. The most commonly performed endovascular treatment was embolization with coils or vascular plugs (81/181 reported cases), followed by embolization associated with a stent-graft in the iliac axis (79/181), occlusion of the origin of the internal iliac artery by deployment of a covered stent alone (15/181), and 6/181 cases of exclusion of the IIIAA by deployment of a covered stent from the hypogastric artery to the superior gluteal artery (SGA).…”

Section: Resultsmentioning

confidence: 99%

“…Reported intraoperative complications were: 1 coil migration (retrieved with a snare), 11 1 bleeding at the percutaneous access site, 15 and 5 large vessels injury during open repair (4 iliac veins, 1 CIA, resulting in massive hemorrhages in 2 cases). 21…”

Section: Resultsmentioning

confidence: 99%

“…Estimated 30-day mortality after any endovascular repair was 2.8% (95% CI 0.5-5.1; I 2 0%, P = .994); after open repair it was 8.2% (95% CI 3.4-19.8; I 2 0%, P = .545). 11,21…”

Section: Resultsmentioning

confidence: 99%

“…Yang et al reported, in their series of 43 IIIAA, 6 endoleaks of which 5 required reintervention. 11 Chemelli et al reported 2 type I endoleak, and 1 reperfusion of the aneurysm sac, all requiring reintervention. 17 The 2 early type II endoleak reported by Haslam et al resolved spontaneously at 1 and 2 years follow-up.…”

Section: Resultsmentioning

confidence: 99%

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Surgical and Endovascular Management of Isolated Internal Iliac Artery Aneurysms: A Systematic Review and Meta-Analysis

Perini

Mariani

Fanelli

et al. 2020

Vasc Endovascular Surg

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Objectives: The purpose of this paper is to report the different modalities for the treatment of isolated internal iliac artery aneurysms (IIIAA), as well as their outcomes. Methods: We performed a systematic review of the literature (database searched: PubMed, Web of Science, Scopus, Cochrane Library; last search: April 2020). We included articles reporting on the outcomes for IIIAA interventions comprising at least 5 patients. Studies were included when presenting extractable outcome data regarding intraoperative and/or early results. We performed meta-analyses of proportions for different outcomes, using random effects model. Results: Thirteen non-randomized studies were included (192 patients with 202 IIIAA). IIIAA were symptomatic in the 18.1% (95%CI 9.3-26.9; I2 54.46%, P = .019). Estimated mean IIIAA diameter was 46.28 mm (95%CI 39.72-52.85; I2 88.85%, P < .001). Open repair was performed in 21/202 cases. Endovascular treatments were: embolization (81/181), embolization and hypogastric artery coverage (79/181), hypogastric artery coverage by stent-grafting (15/181), stent-grafting in the hypogastric artery (6/181). Overall estimated technical success (TS) rate was 91.6% (95% CI 86.8-95.5; I2 45.82%, P = .031). TS rate was 94.5% for open surgery (95%CI 85.3-100; I2 0%, P = .907), and 89.7% for endovascular repair (95%CI 83.8-95.6; I2 55.43%, P = .006). Estimated overall 30-day mortality was 3.1% (95%CI 0.8-5.4; I2 0%, P = .969). Mortality rates after open surgery and endovascular repair were 8.2% (95%CI 3.4-19.8; I2 0%, P = .545) and 2.8% (95%CI 0.5-5.1; I2 0%, P = .994), respectively. Estimated mean follow-up was 32.63 months (95%CI 21.74-43.53; I2 94.45%, P < .001). During this timeframe, IIIAA exclusion was preserved in 92.8% of the patients (95%CI 89.3-96.2; I2 0%, P = .797). Buttock claudication occurred in 13.9% of the patients (95%CI 8.7-19.2; I2 0%, P = .622). Conclusions: IIIAA are frequently large, and symptomatic at presentation. Several treatments are proposed in literature, open and endovascular, both with good results. The endovascular treatment is the preferred method of treatment in literature, since it offers good short- to mid-term results and low early mortality. Buttock claudication after hypogastric artery exclusion is a common complication.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Estimated 30-day mortality after any endovascular repair was 2.8% (95% CI 0.5-5.1; I 2 0%, P = .994); after open repair it was 8.2% (95% CI 3.4-19.8; I 2 0%, P = .545). 11,21…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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