<b><br>Aim:</b> The aim of our study was to assess the outcomes of stent-graft coverage of the hypogastric artery in the management of aortoiliac aneurysms with endovascular aneurysm repair (EVAR).</br> <b><br>Material and methods:</b> From January 2013 to March 2017, a total of 93 patients with aortoiliac aneurysms were treated with EVAR, which required occlusion of one or both of the hypogastric arteries. The patients of the Department of General, Vascular, Endocrine and Transplant Surgery were included in the study continuously and all procedures were elective.</br> <b><br>Results:</b> A total of 93 patients with aortoiliac aneurysms required a unilateral or bilateral procedure. Six patients were excluded from our study because they did not appear at their follow-up appointments. The study included 87 patients (80 men; mean age 71.9 (7.9) years, range 54-88), of which 30 had a unilateral procedure and 57 had a bilateral procedure. In 8 procedures (5.55%, n = 7) there was a type II endoleak that resolved during follow-up and required no surgical intervention. In 10 procedures (6.94%, n = 10) there was a type IB endoleak, with 8 procedures requiring surgical re-intervention in the form of an extension. In 12 procedures (8.33%, n = 9), the hypogastric artery thrombosed.</br> <b><br>Conclusion:</b> Coverage of the hypogastric artery by stent-graft has been proven to be a safe procedure, but there is still a risk of type II endoleak. Although 5.55% (n = 7) of the procedures in our study had a type II endoleak, none required surgical intervention.</br>.
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http://dx.doi.org/10.5604/01.3001.0053.6870 | DOI Listing |
J Vasc Surg Cases Innov Tech
February 2025
Division of Vascular and Endovascular Surgery, Cardio-Thoracic-Vascular Department, Integrated University Healthcare Giuliano-Isontina, University Hospital of Cattinara, Trieste, Italy.
Type II endoleaks after endovascular aortic repair are a common scenario that, although infrequently, may sometimes require secondary interventions when leading to significant enlargement of the aneurysm sac. Herein, we present the perioperative and mid-term results of one of our endovascular aortic repair cases with type II endoleak from the hypogastric artery, whose ostium was covered by the prior stent graft limbs and that were successfully treated with a novel technique employing re-entry catheters in an off-label fashion. This technique may represent a valid alternative solution when conventional access between artery and prosthesis is laborious or impossible to achieve.
View Article and Find Full Text PDFExp Physiol
November 2024
Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.
Ann Vasc Surg
November 2024
Department of Radiology, Nara Medical University, Kashihara, Japan.
Background: Extending the distal sealing zone into the external iliac artery is sometimes necessary during endovascular abdominal aortic repair. As the use of an iliac branch device is contingent upon certain anatomical requirements, the application of this device is not universal. Herein, we present an alternative method to preserve hypogastric artery perfusion using a physician-modified fenestrated (PMF) AFX limb (Endologix, Inc.
View Article and Find Full Text PDFCardiovasc Intervent Radiol
December 2024
Department of Vascular and Endovascular Surgery, Rhein Main Vascular Center, AsklepiosClinicsLangen, Seligenstadt, Wiesbaden, Germany.
Purpose: To evaluate retrospectively the 2-year outcomes of the Gore Excluder Iliac Branch Endoprosthesis (IBE) in patients with and without coexisting hypogastric artery (HA) aneurysms in a large contemporary multicentric European experience using dedicated bridging devices.
Methods: The study included all consecutive patients treated at participating institutions with the Gore Excluder IBE device who received a covered stent (i.e.
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