Intentional internal iliac artery occlusion to facilitate endovascular repair of aortoiliac aneurysms

摘要: Abstract Purpose: The safety of intentional occlusion patent internal iliac arteries (IIAs) to facilitate the endovascular repair aortoiliac artery aneurysms (abdominal aortic [AAAs] and [IAs]) was evaluated. Methods: We analyzed techniques clinical sequelae selective one or both IIAs in 103 patients correlated these findings with results preoperative angiograms identify vascular anatomy that may predict postoperative pelvic ischemia. To quantify presentation ischemia, we developed criteria: class 0, no symptoms; I, nonlimiting claudication exercise; II, new onset impotence, without moderate severe buttock pain, leading physical limitation III, rest colonic both. IIA achieved 100% by means either catheter-directed embolization orificial coverage a stent-graft. No patient this study had angiographic evidence significant visceral occlusive disease before procedure. Sixty-four isolated AAAs, 23 AAAs IAs, 16 IAs. Ninety-two selectively occluded, 11 occluded. Results: After occlusion, 12 were categorized 9 1 for total 22 (21%) Sixteen (17%) 92 unilateral occlusions, six bilateral occlusions. Five I improved symptoms within year, II downgraded because symptoms. Two unique identified remaining (16%) chronic claudication: (1) stenosis origin (> 70%) nonopacification more than three branches (63%); (2) small caliber, diseased absent medial lateral femoral circumflex ipsilateral side (25%). One III ischemia died cardiovascular collapse associated colon infarction caused acute particulate embolization. Conclusion: incidence after is 20% immediately aneurysm repair. A 25% year. radiologic help who are at risk ischemia: deep ascending occluded IIA. appears be AAA (J Vasc Surg 2001;34:204-11.)