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Effect of Endovascular Treatment on Urinary Obstruction Caused by Iliac Artery Aneurysm: A Case Series and Review of the Literature

  • Yan Zhou
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China

    Eight-year Program of Clinical Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
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  • Chaonan Wang
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China
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  • Jiang Shao
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China
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  • Zhichao Lai
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China
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  • Xitao Song
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China
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  • Kang Li
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China
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  • Leyin Xu
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China
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  • Jiangyu Ma
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China

    Eight-year Program of Clinical Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
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  • Xiaoxi Yu
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China

    Eight-year Program of Clinical Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
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  • Wenteng Cao
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China
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  • Xiaolong Liu
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China
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  • Jinghui Yuan
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China
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  • Bao Liu
    Correspondence
    Corresponding authors: Bao Liu, Address: Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China Tel/Fax: +86-10-69152502
    Affiliations
    Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Shuaifuyuan 1st, Dongcheng District, Beijing 100730, People’s Republic of China
    Search for articles by this author
Published:August 01, 2022DOI:https://doi.org/10.1016/j.avsg.2022.07.001

      Abstract

      Objectives

      Endovascular aneurysm repair (EVAR) is superior to open surgery repair (OSR) in multiple aspects and is the mainstay for noninflammatory iliac artery aneurysm (IAA) treatment. However, for noninflammatory IAAs with neighboring structures compressed, the experience of endovascular treatment is limited. This case series study aimed to describe the experience of EVAR of noninflammatory IAAs with urinary obstruction and to review the limited reports in the literature.

      Methods

      From December 2012 to July 2020, we reported seven cases of noninflammatory IAAs combined with urinary obstruction that were treated successfully with endovascular treatment.
      The literature on noninflammatory IAAs combined with urinary obstruction was reviewed using the online databases PubMed, Embase, and the Cochrane Library.

      Results

      Thirty-nine articles were found in the literature. OSR accounted for 80% of the treatment options in previous publications, while only 20% of patients accepted endovascular treatment. Hydronephrosis remission was observed in all patients treated by OSR, while the endovascular treatment group lacked long-term follow-up. In our retrospective study containing 7 cases, no complications, reintervention or mortality was observed, all stents were patent, and all symptoms were relieved after the operation. Diameter reduction of the aneurysms was observed in 6/7 cases, and the average aneurysm reduction was -24.1±15.8 mm (P=0.0097). Urinary obstruction faded in 5/7 cases where aneurysm shrinking was found simultaneously.

      Conclusions

      This case series and literature review on noninflammatory IAAs combined with urinary obstruction suggests that the diameter of the responsible aneurysm may be reduced after endovascular treatment, which may also alleviate symptoms of urinary obstruction caused by noninflammatory IAAs.

      Keywords

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