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Outcomes of open and endovascular repair for ruptured and nonruptured internal iliac artery aneurysms  Muhammad A. Rana, MBBS, Manju Kalra, MBBS, Gustavo.

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Presentation on theme: "Outcomes of open and endovascular repair for ruptured and nonruptured internal iliac artery aneurysms  Muhammad A. Rana, MBBS, Manju Kalra, MBBS, Gustavo."— Presentation transcript:

1 Outcomes of open and endovascular repair for ruptured and nonruptured internal iliac artery aneurysms  Muhammad A. Rana, MBBS, Manju Kalra, MBBS, Gustavo S. Oderich, MD, Eileen de Grandis, MD, Peter Gloviczki, MD, Audra A. Duncan, MD, Steven S. Cha, MS, Thomas C. Bower, MD  Journal of Vascular Surgery  Volume 59, Issue 3, Pages (March 2014) DOI: /j.jvs Copyright © 2014 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Technique for internal iliac artery (IIA) revascularization during open internal iliac artery aneurysm (IIAA) aneurysm repair. A, Aorto-iliac graft limb is first anastomosed end to end to the external iliac artery. B, Separate graft is then anastomosed distally to the IIA bifurcation in an end to end manner often by using the parachuting technique. C, Distal control deep in the pelvis can be facilitated by balloon catheter control of IIA branches. D, The graft is then trimmed to length and anastomosed in an end to side manner to the aorto-external iliac limb. Published by permission of the Mayo Foundation for Medical Education and Research. All rights reserved. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Anatomy and extent of treated aneurysms.
Published by permission of the Mayo Foundation for Medical Education and Research. All rights reserved. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Details of open surgical reconstructions of internal iliac artery aneurysms (IIAAs) in 60 patients. Published by permission of the Mayo Foundation for Medical Education and Research. All rights reserved. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

5 Fig 4 Details of endovascular reconstructions of internal iliac artery aneurysms (IIAAs) in 37 patients. aOne of the four patients treated with aortoiliac stent grafting and unilateral iliac branch device (IBD) had a prior thrombosed contralateral nonaneurysmal internal iliac artery (IIA). Published by permission of the Mayo Foundation for Medical Education and Research. All rights reserved. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

6 Fig 5 A, Overall actuarial survival in 97 patients following internal iliac artery aneurysm (IIAA) repair. B, Survival following open repair (OR) and internal iliac endovascular aneurysm repair (II-EVAR). C, Survival following emergent and elective repairs. D, Five-year patency of 45 internal iliac artery (IIA) reconstructions. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

7 Fig 6 A, Overall actuarial freedom from buttock claudication following internal iliac artery aneurysm (IIAA) repair. B, Freedom from buttock claudication following open repair (OR) and internal iliac endovascular aneurysm repair (II-EVAR). C, Freedom from buttock claudication following preservation of none, one and both internal iliac arteries (IIAs). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

8 Fig 7 A, Nine-cm left internal iliac artery aneurysm (IIAA) in a 69-year-old male causing iliac vein compression and sciatic neuropathy. This was repaired with endoaneurysmorrhaphy alone. B, Computed tomography angiography demonstrating 10.5-cm right and 4.6 cm left IIAA in a patient with prior proximal right internal iliac artery (IIA) ligation and aorta to right external iliac and left common iliac artery reconstruction for aneurysmal disease. These aneurysms were treated with endoaneurysmorrhaphy alone on the right and IIA bypass on the left. C, Follow-up computed tomography angiography after repair of an isolated 4.5 cm left IIAA repaired with an iliac branch device (IBD) 10 years after open repair (OR) of aortoiliac aneurysm with reimplantation of the inferior mesenteric artery (IMA) and multiple renal arteries. D, Follow-up computed tomography angiography 26 months following aortoiliac reconstruction with bilateral IIA preservation demonstrating widely patent bypass grafts. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

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