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Endovascular Therapeutic Options for Isolated Iliac Aneurysms with a Working Classification

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Abstract

The purpose of this paper is to demonstrate a variety of stent-grafting and embolization techniques and describe a new classification for endovascular treatment of isolated iliac artery aneurysms. A total of 19 patients were treated for isolated iliac aneurysms. Depending on the proximal iliac neck and the uni-/bilaterality of common iliac artery aneurysms (CIAA’s) the patient may be treated by a tube (Type Ia) or a bifurcated stent-graft (Type Ib) in addition to internal iliac artery embolization. Neck anatomy is also critical in determining therapeutical options for internal iliac artery aneurysms (IIAA’s). These are tube stent-grafting plus internal iliac branch embolization (Type IIa), coiling of afferent and efferent internal iliac vessels (Type IIb) and IIAA packing (Type IIc). The average length of stay for these procedures was 3.8 days. During the mean follow-up of 20.9 months, aneurysm size remained unchanged in all but 4 patients. Reinterventions were necessary in option Type Ib (3/8 pat.) and Type Ia (1/7 pat.) due to extender stent-graft migration (n = 2) or reperfusion leaks (n = 2). We conclude that Iliac artery aneurysms may be successfully and safely treated by a tailored approach using embolization or a combination of embolization and stent-grafting. Long-term CT imaging follow-up is necessary, particularly in patients treated with bifurcated stent-grafts (Type Ib).

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Acknowledgements

We thank Mr. Peter Roth, illustrator at the clinic of neurosurgery of our hospital for his helpful drawings.

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Authors and Affiliations

  1. Department of Radiology, University Hospital of Zurich, Zurich, Switzerland

    Markus Fahrni, Simon Wildermuth & Thomas Pfammatter

  2. Clinic of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland

    Mario M Lachat

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  1. Markus Fahrni
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  2. Mario M Lachat
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  3. Simon Wildermuth
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  4. Thomas Pfammatter
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Correspondence to Thomas Pfammatter.

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Fahrni, M., Lachat, M., Wildermuth, S. et al. Endovascular Therapeutic Options for Isolated Iliac Aneurysms with a Working Classification . CVIR 26, 443–447 (2003). https://doi.org/10.1007/s00270-003-0005-1

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  • DOI: https://doi.org/10.1007/s00270-003-0005-1

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