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How safe is internal iliac artery embolisation prior to EVAR? A 10-year retrospective review

Irish Journal of Medical Science (1971 -) volume 185, pages 865–869 (2016)Cite this article

Abstract

Purpose

Internal iliac artery (IIA) embolisation is commonly performed prior to endovascular aneurysm repair (EVAR) of aortoiliac aneurysms to prevent type 2 endoleaks via the internal iliac arteries. The safety of this procedure is controversial due to the high incidence of pelvic ischaemic complications.

Methods

We undertook a retrospective review of all patients undergoing IIA embolisation before EVAR from 2002 to 2012, to determine incidence of, and factors associated with pelvic ischaemia.

Results

Eight of 25 patients (32 %) experienced new-onset ischaemia, including erectile dysfunction (4 %), and buttock claudication (28 %) that persisted >6 months in only four patients (16 %). Both bilateral IIA embolisation and a shorter time interval to EVAR correlate with increased risk (p = 0.006 and p = 0.044). No co-morbidities or demographic factors were predictive.

Conclusions

We conclude that IIA embolisation remains a beneficial procedure, however, to minimise the risk of buttock claudication we advise against both bilateral IIA embolisation and short time intervals between embolisation and subsequent EVAR.

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Affiliations

  1. Department of Academic Radiology, Beaumont Hospital Dublin, Dublin, Ireland

    J. G. McGarry, A. O. Alenezi, F. P. McGrath, M. F. Given, A. N. Keeling & M. J. Lee

  2. Department of Surgery, Beaumont Hospital Dublin, Dublin, Ireland

    D. S. Moneley & A. L. Leahy

  3. Faculty of Radiology, Royal College of Surgeons in Ireland, Dublin, Ireland

    A. L. Leahy & M. J. Lee

Authors
  1. J. G. McGarry
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  2. A. O. Alenezi
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  3. F. P. McGrath
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  4. M. F. Given
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  5. A. N. Keeling
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  6. D. S. Moneley
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  7. A. L. Leahy
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  8. M. J. Lee
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Corresponding author

Correspondence to J. G. McGarry.

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Conflict of interest

None of the authors (Dr J. McGarry, Mr A. Alenezi, Dr F. McGrath, Dr M. Given, Dr A. Keeling, D. Moneley, A. Leahy, or Prof M Lee) has a conflict of interest or source of funding to declare.

Ethical approval

This retrospective study is entirely in accordance with the ethical standards of Beaumont Hospital Dublin Ethics Committee.

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McGarry, J.G., Alenezi, A.O., McGrath, F.P. et al. How safe is internal iliac artery embolisation prior to EVAR? A 10-year retrospective review. Ir J Med Sci 185, 865–869 (2016). https://doi.org/10.1007/s11845-015-1384-4

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  • DOI: https://doi.org/10.1007/s11845-015-1384-4

Keywords

  • Aortoiliac aneurysm
  • EVAR
  • Internal iliac artery
  • Embolisation
  • Pelvic ischemia
  • Buttock claudication