Bilateral Hypogastric Artery Occlusion in Endovascular Repair of Abdominal Aortic Aneurysms and Its Clinical Significance

Zander, Tobías; Baldi, S.; Rabellino, Martín; Rostagno, Román; Isaza, Baltasar; Llorens, R.; Carreira, José M.; Maynar, Manuel

doi:10.1016/j.jvir.2007.07.034

Cited by 42 publications

(29 citation statements)

References 22 publications

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“…22,25,26 Unlike the overall study group and OBG patients, no significant difference was seen in complication rate with ligation vs embolization, possibly because of previously blocked collaterals by JOURNAL OF VASCULAR SURGERY Volume -, Numberatherosclerotic disease. No significant difference in complication rate was found with regard to site of LEC and embolization material.…”

Section: Discussionmentioning

confidence: 92%

Consequences of hypogastric artery ligation, embolization, or coverage

Chitragari

Schlösser

Chaar

et al. 2015

Journal of Vascular Surgery

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Interruption of the hypogastric artery is relatively safe in young and OBG patients compared with vascular surgery and oncology patients. Ligation of the hypogastric arteries is preferred to embolization, and proximal embolization should be preferred to distal embolization to decrease the risk of ischemic complications. Randomized controlled trials with larger sample size are needed to definitively elucidate clear risk factors for development of complications after hypogastric artery interruption.

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Section: Discussionmentioning

confidence: 92%

Consequences of hypogastric artery ligation, embolization, or coverage

Chitragari

Schlösser

Chaar

et al. 2015

Journal of Vascular Surgery

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“…[2][3][4] Ischemic complications are rare after EVAR, but have included colon, 8 spinal cord, 9 and bladder ischemia, with the most common being acute limb ischemia due to stent graft limb occlusion. [3][4][5][6][7][8][9][10] To our knowledge, this is the first case report of ischemic testicular infarction after advanced endovascular therapy to treat an aortoiliac artery aneurysm.…”

Section: Discussionmentioning

confidence: 81%

“…3,4 Aortoiliac aneurysms are often considered for endovascular treatment by embolic exclusion of the internal iliac artery to allow conventional endovascular treatment with a bifurcated endograft with limb extension to the external iliac artery. [5][6][7] This elective embolization of the internal iliac artery, which prevents a type II endoleak and loss of antegrade internal iliac artery flow, is considered safe because collateral pelvic circulation is often adequate to prevent all but transient buttock claudication, the most common ischemic sequelae. 6,7 Here we present what we believe is a previously unreported complication of endovascular therapy, namely, ischemic testicular infarction after treatment of an aortoiliac aneurysm by coil embolization of ipsilateral internal iliac artery, followed by EVAR.…”

mentioning

confidence: 99%

Testicular infarction: A rare complication of endovascular aneurysm repair treatment for aortoiliac aneurysm

McKenna¹,

Gambardella²,

Collins³

et al. 2009

Journal of Vascular Surgery

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Endovascular aneurysm repair (EVAR) is an established therapy to prevent rupture in large infrarenal abdominal aortic aneurysms (AAA). As experience with this therapy has grown, treatment of more challenging anatomy has led to the identification of several new procedurally related complications. We report the case of a 67-year-old man with an asymptomatic, large infrarenal AAA with an associated left common iliac artery aneurysm. Endovascular therapy for an aortoiliac aneurysm involved prior coil embolization of his left internal iliac artery to allow conventional EVAR with extension to the external iliac artery of the left graft limb, thus excluding the left iliac aneurysm. He presented 6 weeks postoperatively with onset of left-sided scrotal pain and underwent emergency orchidectomy for ischemic infarction of his left testis. The histology report confirmed that the left testis was necrotic secondary to a thrombus in the testicular artery. To our knowledge, this is the first report of testicular infarction after EVAR.

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“…On the other hand, coil embolization of the bilateral IIAs in EVAR has been considered safer compared with their ligation during open surgery. [20][21][22][23] However, it has been documented that it can lead to ischemic colitis 8 or persistent spinal cord deficiency, 9 and buttock claudication is a major complication with a reported incidence of up to 63%. 24 Unno et al 13 examined the intraoperative penile and gluteal blood flow during EVAR with unilateral IIA occlusion and contralateral IIA revascularization.…”

Section: Discussionmentioning

confidence: 99%