Highlights
- -Different iliac branch devices have been developed for treatment of aorto-iliac or iliac aneurysms.
- -Internal Iliac Artery embolization could lead to ischemic complications such as buttock claudication, erectile dysfunction, spinal cord or pelvic ischemia.
- -In recent years, the preservation of IIA during EVAR for iliac aneurysmatic disease has become possible with IBD.
- -IBD show an encouraging sustained durability in terms of flow patency and freedom from reintervention.
Abstract
Background
The aim of study was to assess the safety and effectiveness of 3 different commercial
iliac branch devices (IBDs): the Zenith Branch Iliac Endovascular Graft; the Gore
Excluder Iliac Branch System and the E-liac Stent Graft System for the treatment of
aorto-iliac or iliac aneurysms.
Methods
From January 2017 to February 2020, a retrospective reviewed was conducted on a total
of 96 patients. Primary endpoint was IBD instability rate at 24-months. Secondary
endpoints included onset of any endoleaks, buttock claudication, IBD-related reintervention
and all-death rates, post-operative acute kidney and changes in maximum diameter from
baseline of the aortic aneurysmal sac.
Results
At 24 months, the branch instability rate was similar amongst the three IBDs employed
[Jotec 1/24 (4.1%), Gore 1/12 (8.3%), Cook 6/47 (12.7%), p-value = 0.502]. As well,
no statistical difference in terms of branch-occlusion and branch-related endoleaks
was observed. The Jotec group showed a significant decrease in maximum diameter from
the baseline of the aortic aneurysmal sac when compared to the Gore group alone. No
other differences were found relevant to the onset of any endoleaks, reinterventions
and all-death rates. At 24-months, the Kaplan-Meier estimate of survival freedom from
any branch instability was 95.8%, 91.6% and 86.8% for Jotec, Gore and Cook groups,
respectively.
Conclusions
The use of IBDs represents a safe method for preserving patency of the IIA during
treatment of aorto-iliac or iliac aneurysms providing a low rate of IBD instability.
Keywords
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Article info
Publication history
Accepted:
February 24,
2023
Received in revised form:
February 23,
2023
Received:
December 14,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
There are no financial conflicts of interest to disclose.
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
