Novel-designed iliac branch stent graft for internal iliac artery reconstruction during aneurysm repair.

Background: Iliac branch stent grafts (IBSGs) have been used for internal iliac artery preservation during aneurysm repair. However, current available branch iliac stent grafts used in Western countries are not suitable for many patients in Asia because of shorter common iliac arteries (CIA). The aim of this study was to evaluate the efficacy of a novel-designed IBSG in preservation of internal iliac artery during endovascular aneurysm repair in Chinese.

Methods: Eleven male patients (range, aged 65-80 years) underwent endovascular repair with 15 IBSGs, including 4 bilateral repairs between January 2011 and December 2012. The median abdominal aortic aneurysm diameter was 50 mm and the common iliac diameter was 38 mm. All patients received computed tomography angiography (CTA) before discharge and every 3 months afterward.

Results: The stent-graft deployment was technically successful in all cases. Seven of the 11 patients had uneventful procedures and the rest 4 complicated with fever, renal insufficiency, and groin hematoma. The median length of hospitalization was 7 days. Perioperative mortality was zero. Follow-up documented that 1 patient died at 14 months after surgery because of an unrelated cause. Two patients were found to have a type I and III endoleak, respectively, then successful treatments with internal iliac artery extension stent grafts were applied at 6 months. The overall primary patency was 86.7%. Follow-up CTA showed aneurysm shrinkage in all patients.

Conclusions: These novel-designed IBSGs are safe and effective in preservation of internal iliac artery. It provides an alternative option for endovascular repair of the iliac aneurysms with short CIA, which is more common in Asian population.