20 - Freie Mitteilung
15. Mai 2019, 13:30 - 15:00, Sopra Grande, 4. OG
Single centre experience with the GORE EXCLUDER® iliac branch endoprosthesis for endovascular iliac aneurysm repair
S. Hofer, K. Pavotbawan, M. Furrer, Presenter: S. Hofer (Chur)
Adequate sealing and preserving of the hypogastric artery in patients with iliac artery aneurysms can be achieved with endovascular strategies using iliac branch devices. The aim of this study was to examine short and midterm outcome using the GORE EXCLUDER® iliac branch endoprosthesis (IBE).
Between September 2015 and December 2018 34 IBE were implanted in 28 patients with aneurysm of the common iliac artery (CIAA) or aneurysm of the hypogastric artery (HAA). Postoperative outcome was assessed by CT scan on day one, day 90 and thereafter once yearly after surgery.
In six of the included 28 patients we performed a bilateral repair by IBE. Indications for IBE were a CIAA in 22 patients, a HAA in five patients and a combination of CIAA and HAA in seven patients. We combined 14 IBEs with an aortobiiliac stentgraft implantation, in 20 cases we implanted IBE without an aortic extension. Seven patients presented with an iliac aneurysm harbouring additionally an aortic aneurysm requiring treatment. A technically successful endovascular repair was performed in 33 patients (97%). A conversion to open repair was necessary in one patient due to stentgraft dislocation. One patient showed an early occlusion of the hypogastric artery (3%). Early reintervention was required in four patients due to two stentgraft stenoses, one endoleak type I and one stentgraft dislocation. During a mean follow-up time of 12 months (range 0-36 months) the patency rate was 100% . A reintervention during follow-up time was performed in three patients (8.8 %) because of an endoleak type I after three and 25 months and an endoleak type III after 27 months. Sac shrinking could be achieved in 22 aneurysms. No buttock claudication occurred.
Using a IBE is an effective and safe option for CIAA and HAA, avoiding complications asssociated with intentional occlusion of internal iliac artery. Short and midterm outcome shows a very good patency and a low complication rate.