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Interventional Exclusion of Iliac Artery Aneurysms Using the Flow-Diverting Multilayer Stent

Abstract

Purpose

This study was designed to evaluate retrospectively the results of complex iliac artery aneurysm (IAA) exclusion using the Cardiatis-Multilayer-Stent.

Methods

Between October 2010 and August 2012, ten IAAs were treated in eight males (mean age 75 (59–91) years) using the Multilayer Stent. All IAA exceeded a diameter of 3 cm or were symptomatic. Follow-up (FU) examinations included CT or MR angiography, sonography, and clinical assessment up to 2 years.

Results

Primary stent placement was technically successful in eight of ten cases. In two cases, severe stent retraction during deployment necessitated placement of an additional stent. Immediately after stent placement, a marked reduction of flow within the sac was observed in all cases (peri-interventional mortality 0 %). During FU, there were two thrombotic stent occlusions, making reintervention necessary (primary patency rate 80 %, secondary patency 100 %). Four IAA were completely occluded at FU, whereas the original vessel and covered branches (n = 8) were patent. In four IAA, there was still residual perfusion. In one patient, IAA diameter decreased slightly, while it remained constant in seven (mean imaging FU 195 (range 1–695) days). There were no adverse events on clinical FU (mean FU 467 (range 101–695) days).

Conclusions

Other studies showed the Cardiatis-Multilayer-Stent to be a technically relatively simple treatment option for complex IAA with inadequate landing zones, especially in patients with multiple comorbidities to avoid ipsilateral IIA obstruction. However, in our series complication rate was high. Incomplete sac exclusion, stent-shortening, and thrombotic occlusion can complicate treatment, making meticulous patient selection necessary. Close imaging surveillance is mandatory especially in the early postinterventional period.

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Acknowledgments

The authors thank Dr. med. Jörg Thalwitzer (Department of Radiology, Heinrich-Braun-Klinikum, Zwickau) and Dr. med. Albrecht Bormann (Department of Radiology, Klinikum Altenburger Land, Altenburg) for their contribution and support.

Conflict of interest

All authors declare that they have no conflict of interest.

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Correspondence to Claus Christian Pieper.

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Pieper, C.C., Meyer, C., Rudolph, J. et al. Interventional Exclusion of Iliac Artery Aneurysms Using the Flow-Diverting Multilayer Stent. Cardiovasc Intervent Radiol 36, 917–925 (2013). https://doi.org/10.1007/s00270-013-0639-6

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  • DOI: https://doi.org/10.1007/s00270-013-0639-6

Keywords

  • Multilayer Stent
  • Iliac artery aneurysm
  • Flow-diverter stent
  • Interventional aneurysm repair