Objective: To summarize the surgical experiences of treating 61 cases of non-traumatic aneurysms in ilio-femoral arterial region.
Methods: The clinical data of 61 consecutive patients with non-traumatic aneurysms in ilio-femoral arterial region between January 1985 and November 2010 were retrospectively reviewed.
Results: There were a total of 76 non-traumatic aneurysms in ilio-femoral arterial region, including solitary iliac aneurysms (n = 29) and femoral aneurysms (n = 32). Seventeen (27.9%) patients had multiple aneurysms, 8 (13.1%) patients ruptured aneurysms and 4 (6.6%) patients coexistent peripheral vascular occlusive disease. Fifty patients underwent electively aneurysm excision and graft (or autogenous vein) replacement. Seven patients with ruptured aneurysms received emergency treatment. And one with multiple aneurysms died intra-operatively from ruptured iliac aneurysm. One patient with common iliac aneurysm underwent endovascular repair without endoleak and 1 with internal iliac aneurysm received embolization. There was no perioperative mortality. But one with femoral aneurysm underwent amputation due to acute thrombosis. Seven patients died during the follow-up period and the survivors remained stable and had a good graft patency without new aneurysm formation.
Conclusion: Early management of aneurysms in ilio-femoral arterial region is rather important and multiple aneurysms should be considered. Aneurysm excision and arterial reconstruction yield an excellent outcome. Close and long-term follow-up is mandatory for the detection of new aneurysm formation.
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Article Synopsis
- - The study focuses on vascular complications during transfemoral transcatheter aortic valve implantation (TAVI) and introduces a new risk score called the passage-puncture score to assess the best access site.
- - This score evaluates two factors: the feasibility of accessing the ilio-femoral arteries (passage score) and the suitability of the puncture site (puncture score) using pre-procedure CT scans.
- - Results showed that using the passage-puncture score helped identify safer access points and led to a low rate of minor vascular complications (6%) in the patients studied.
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