Buttock Claudication After Interventional Occlusion of the Hypogastric Artery—A Mid-Term Follow-Up

Abstract

Buttock claudication after occlusion of the HA prior to EVAR is a frequent complication, which often persists during follow-up. Alternatives that maintain pelvic perfusion should be considered.

Consequences of hypogastric artery ligation, embolization, or coverage

“…8 Vascular surgery and oncology patients tend to be relatively old. 7,[9][10][11][12] This may play a role in the different rates and types of complications reported in different groups (Table VIII). It is widely appreciated that increased age is an independent risk factor for the development of atherosclerosis, which leads to occlusive disease.…”

Endovascular Aneurysm Repair of Aortoiliac Aneurysms with an Iliac Side-branched Stent graft: Studying the Morphological Applicability of the Cook Device

“…Sacrificing the pelvic blood flow for EVAR can result in buttock claudication or new onset erectile dysfunction. 2,3,18 This may then dramatically impair patients' quality of life, especially in those of younger age and with an active lifestyle. The iliac side-branched stent grafts create a landing zone in the IIA and EIA, thereby offering the possibility of preserving blood flow to the pelvis, and are therefore a promising alternative to endovascular repair with occlusion of the IIA.…”

“…However, sacrificing the pelvic blood flow often results in buttock claudication and impotence. 1 The frequency of these complications varies between 13% and 55%, 2,3 and they can impair quality of life substantially.…”

A multicenter 12-month experience with a new iliac side-branched device for revascularization of hypogastric arteries

“…5 Although it is usually well tolerated, occlusion of the IIA can cause ischemic manifestations after EVAR, such as buttock claudication, sexual dysfunction, and colonic ischemia. [6][7][8] In a study that included data from 18 papers dealing with IIA embolization before EVAR, buttock claudication occurred in 55% of patients overall, with 52% occurring after unilateral embolization and 63% occurring after bilateral embolization. Erectile dysfunction occurred in 17% overall, with 17% occurring after unilateral embolization and 24% occurring after bilateral embolization.…”