Skip to main content
Erschienen in: CardioVascular and Interventional Radiology 5/2018

03.01.2018 | Clinical Investigation

Initial Experience with the E-liac® Iliac Branch Device for the Endovascular Aortic Repair of Aorto-iliac Aneurysm

verfasst von: Susanne Anton, Marcus Wiedner, Erik Stahlberg, Fabian Jacob, Jörg Barkhausen, Jan Peter Goltz

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 5/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Occlusion of internal iliac arteries during endovascular treatment (EVAR) of abdominal aortic (AAA) and common iliac artery aneurysms might be associated with ischemic pelvic complications. This study evaluates technical and clinical success, safety and mid-term results of a novel iliac branch device (IBD) for revascularization of the internal iliac artery (IIA) during EVAR.

Materials and Methods

Retrospectively, we identified 21 men (mean age 73.3 ± 6.2 years) treated for aorto-iliac aneurysms by use of a novel IBD (E-liac®, Jotec Hechingen, Germany). We analyzed safety (30-day survival), technical (no type I and III endoleaks, “EL”), clinical (no ischemic complications) success, mid-term patency of this IBD, peri-procedural complications, occurrence of type II ELs, rate of re-interventions and additional treatment of the revascularized IIA for landing zone preparation.

Results

Twenty-three IBDs were implanted. Aneurysms of the ipsilateral IIA were present in 6/23 IIAs (26.1%). Super-selective branch embolization was performed in these patients and the landing zone for the iliac sidebranch stent-graft was within the superior gluteal artery. Mean follow-up was 341 days (range 4–1103 days). Technical success and 30-day survival were 100%. Clinical success was 95.2%. Primary patency of the IBDs was 100% at 12 months. Peri-procedural complications occurred in 3/21 patients (14.3%), none of them related to the IBD. AAA-related type II ELs were found in 6 patients (28.6%), IBD-related ELs in 4/23 IBDs (17.4%) (two type Ib, two type II endoleaks). Overall re-intervention rate was 23.8%, IBD-related 8.7%.

Conclusion

Utilization of the E-liac® IBD is safe and effective for the treatment of aorto-iliac aneurysms.
Literatur
1.
Zurück zum Zitat Hertzer NR, Mascha EJ, Karafa MT, et al. Open infrarenal abdominal aortic aneurysm repair: the Cleveland Clinic experience from 1989 to 1998. J Vasc Surg. 2002;35:1145–54.CrossRefPubMed Hertzer NR, Mascha EJ, Karafa MT, et al. Open infrarenal abdominal aortic aneurysm repair: the Cleveland Clinic experience from 1989 to 1998. J Vasc Surg. 2002;35:1145–54.CrossRefPubMed
2.
Zurück zum Zitat Ballard DJ, Filardo G, Graca B, et al. Clinical practice change requires more than comparative effectiveness evidence: abdominal aortic aneurysm management in the USA. J Comp Eff Res. 2012;1:31–44.CrossRefPubMed Ballard DJ, Filardo G, Graca B, et al. Clinical practice change requires more than comparative effectiveness evidence: abdominal aortic aneurysm management in the USA. J Comp Eff Res. 2012;1:31–44.CrossRefPubMed
3.
Zurück zum Zitat Sachs T, Schermerhorn M, Pomposelli F, et al. Resident and fellow experiences after the introduction of endovascular aneurysm repair for abdominal aortic aneurysm. J Vasc Surg. 2011;54:881–8.CrossRefPubMedPubMedCentral Sachs T, Schermerhorn M, Pomposelli F, et al. Resident and fellow experiences after the introduction of endovascular aneurysm repair for abdominal aortic aneurysm. J Vasc Surg. 2011;54:881–8.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Chemelli A, Hugl B, Klocker J, et al. Endovascular repair of isolated iliac artery aneurysms. J Endovasc Ther. 2010;17:492–503.CrossRefPubMed Chemelli A, Hugl B, Klocker J, et al. Endovascular repair of isolated iliac artery aneurysms. J Endovasc Ther. 2010;17:492–503.CrossRefPubMed
5.
Zurück zum Zitat Armon MP, Wenham PW, Whitaker SC, et al. Common iliac artery aneurysms in patients with abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 1998;15:255–7.CrossRefPubMed Armon MP, Wenham PW, Whitaker SC, et al. Common iliac artery aneurysms in patients with abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 1998;15:255–7.CrossRefPubMed
6.
Zurück zum Zitat Mylonas SN, Rumenapf G, Schelzig H, et al. A multicenter 12-month experience with a new iliac side-branched device for revascularization of hypogastric arteries. J Vasc Surg. 2016;64(6):1652–9.CrossRefPubMed Mylonas SN, Rumenapf G, Schelzig H, et al. A multicenter 12-month experience with a new iliac side-branched device for revascularization of hypogastric arteries. J Vasc Surg. 2016;64(6):1652–9.CrossRefPubMed
7.
Zurück zum Zitat Melas N, Saratzis A, Dixon H, et al. Isolated common iliac artery aneurysms: a revised classification to assist endovascular repair. J Endovasc Ther. 2011;18:697–715.CrossRefPubMed Melas N, Saratzis A, Dixon H, et al. Isolated common iliac artery aneurysms: a revised classification to assist endovascular repair. J Endovasc Ther. 2011;18:697–715.CrossRefPubMed
8.
Zurück zum Zitat Papazoglou KO, Sfyroeras GS, Zambas N, et al. Outcomes of endovascular aneurysm repair with selective internal iliac artery coverage without coil embolization. J Vasc Surg. 2012;56:298–303.CrossRefPubMed Papazoglou KO, Sfyroeras GS, Zambas N, et al. Outcomes of endovascular aneurysm repair with selective internal iliac artery coverage without coil embolization. J Vasc Surg. 2012;56:298–303.CrossRefPubMed
9.
Zurück zum Zitat Ghosh J, Murray D, Paravastu S, et al. Contemporary management of aorto-iliac aneurysms in the endovascular era. Eur J Vasc Endovasc Surg. 2009;37:182–8.CrossRefPubMed Ghosh J, Murray D, Paravastu S, et al. Contemporary management of aorto-iliac aneurysms in the endovascular era. Eur J Vasc Endovasc Surg. 2009;37:182–8.CrossRefPubMed
10.
Zurück zum Zitat Heckenkamp J, Brunkwall J, Luebke T, et al. Novel chimney-graft technique for preserving hypogastric flow in complex aortoiliac aneurysms. J Cardiovasc Surg (Torino). 2012;53(6):773–6. Heckenkamp J, Brunkwall J, Luebke T, et al. Novel chimney-graft technique for preserving hypogastric flow in complex aortoiliac aneurysms. J Cardiovasc Surg (Torino). 2012;53(6):773–6.
11.
Zurück zum Zitat Kotsis T, Tsanis A, Sfyroeras G, et al. Endovascular exclusion of symptomatic bilateral common lliac artery aneurysms with preservation of an aneurysmal internal lliac artery via a reverse-U stent-graft. J Endovasc Ther. 2006;13:158–63.CrossRefPubMed Kotsis T, Tsanis A, Sfyroeras G, et al. Endovascular exclusion of symptomatic bilateral common lliac artery aneurysms with preservation of an aneurysmal internal lliac artery via a reverse-U stent-graft. J Endovasc Ther. 2006;13:158–63.CrossRefPubMed
12.
Zurück zum Zitat Parlani G, Verzini F, De Rango P, et al. Long-term results of iliac aneurysm repair with iliac branched endograft: a 5-year experience on 100 consecutive cases. Eur J Vasc Endovasc Surg. 2012;43:287–92.CrossRefPubMed Parlani G, Verzini F, De Rango P, et al. Long-term results of iliac aneurysm repair with iliac branched endograft: a 5-year experience on 100 consecutive cases. Eur J Vasc Endovasc Surg. 2012;43:287–92.CrossRefPubMed
13.
Zurück zum Zitat Wong S, Greenberg RK, Brown CR, et al. Endovascular repair of aortoiliac aneurysmal disease with the helical iliac bifurcation device and the bifurcated-bifurcated iliac bifurcation device. J Vasc Surg. 2013;58:861–9.CrossRefPubMed Wong S, Greenberg RK, Brown CR, et al. Endovascular repair of aortoiliac aneurysmal disease with the helical iliac bifurcation device and the bifurcated-bifurcated iliac bifurcation device. J Vasc Surg. 2013;58:861–9.CrossRefPubMed
14.
Zurück zum Zitat Moll FL, Powell JT, Fraedrich G, et al. Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery. Eur J Vasc Endovasc Surg. 2011;41(Suppl 1):S1–58.CrossRefPubMed Moll FL, Powell JT, Fraedrich G, et al. Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery. Eur J Vasc Endovasc Surg. 2011;41(Suppl 1):S1–58.CrossRefPubMed
15.
Zurück zum Zitat Buck DB, Bensley RP, Darling J, et al. The effect of endovascular treatment on isolated iliac artery aneurysm treatment and mortality. J Vasc Surg. 2015;62:331–5.CrossRefPubMedPubMedCentral Buck DB, Bensley RP, Darling J, et al. The effect of endovascular treatment on isolated iliac artery aneurysm treatment and mortality. J Vasc Surg. 2015;62:331–5.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat van Sterkenburg SM, Heyligers JM, van Bladel M, et al. Experience with the GORE EXCLUDER iliac branch endoprosthesis for common iliac artery aneurysms. J Vasc Surg. 2016;63:1451–7.CrossRefPubMed van Sterkenburg SM, Heyligers JM, van Bladel M, et al. Experience with the GORE EXCLUDER iliac branch endoprosthesis for common iliac artery aneurysms. J Vasc Surg. 2016;63:1451–7.CrossRefPubMed
17.
Zurück zum Zitat Loth AG, Rouhani G, Gafoor SA, et al. Treatment of iliac artery bifurcation aneurysms with the second-generation straight iliac bifurcated device. J Vasc Surg. 2015;62:1168–75.CrossRefPubMed Loth AG, Rouhani G, Gafoor SA, et al. Treatment of iliac artery bifurcation aneurysms with the second-generation straight iliac bifurcated device. J Vasc Surg. 2015;62:1168–75.CrossRefPubMed
18.
Zurück zum Zitat Pua U, Tan K, Rubin BB, et al. Iliac branch graft in the treatment of complex aortoiliac aneurysms: early results from a North American institution. J Vasc Interv Radiol. 2011;22:542–9.CrossRefPubMed Pua U, Tan K, Rubin BB, et al. Iliac branch graft in the treatment of complex aortoiliac aneurysms: early results from a North American institution. J Vasc Interv Radiol. 2011;22:542–9.CrossRefPubMed
19.
Zurück zum Zitat Karthikesalingam A, Parmar J, Cousins C, et al. Midterm results from internal iliac artery branched endovascular stent-grafts. Vasc Endovasc Surg. 2010;44:179–83.CrossRef Karthikesalingam A, Parmar J, Cousins C, et al. Midterm results from internal iliac artery branched endovascular stent-grafts. Vasc Endovasc Surg. 2010;44:179–83.CrossRef
20.
Zurück zum Zitat Dias NV, Resch TA, Sonesson B, et al. EVAR of aortoiliac aneurysms with branched stent-grafts. Eur J Vasc Endovasc Surg. 2008;35:677–84.CrossRefPubMed Dias NV, Resch TA, Sonesson B, et al. EVAR of aortoiliac aneurysms with branched stent-grafts. Eur J Vasc Endovasc Surg. 2008;35:677–84.CrossRefPubMed
21.
Zurück zum Zitat Noel-Lamy M, Jaskolka J, Lindsay TF, et al. Internal iliac aneurysm repair outcomes using a modification of the iliac branch graft. Eur J Vasc Endovasc Surg. 2015;50:474–9.CrossRefPubMed Noel-Lamy M, Jaskolka J, Lindsay TF, et al. Internal iliac aneurysm repair outcomes using a modification of the iliac branch graft. Eur J Vasc Endovasc Surg. 2015;50:474–9.CrossRefPubMed
22.
Zurück zum Zitat Maus V, Kurz P, Sommer CM, et al. The use of iliac side branch devices in patients with aortoiliac aneurysm. Fortschr Roentgenstr. 2016;188:746–52.CrossRef Maus V, Kurz P, Sommer CM, et al. The use of iliac side branch devices in patients with aortoiliac aneurysm. Fortschr Roentgenstr. 2016;188:746–52.CrossRef
Metadaten
Titel
Initial Experience with the E-liac® Iliac Branch Device for the Endovascular Aortic Repair of Aorto-iliac Aneurysm
verfasst von
Susanne Anton
Marcus Wiedner
Erik Stahlberg
Fabian Jacob
Jörg Barkhausen
Jan Peter Goltz
Publikationsdatum
03.01.2018
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 5/2018
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-017-1868-x

Weitere Artikel der Ausgabe 5/2018

CardioVascular and Interventional Radiology 5/2018 Zur Ausgabe

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärztinnen und Psychotherapeuten.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.