Gluteal Blood Flow Monitoring in Endovascular Aneurysm Repair With Internal Iliac Artery Embolization

Abstract

paring changes in rSO2 with treatment results. Methods Of the 86 patients who underwent EVAR at our institution between April 2019 and May 2020, 27 patients were included and 2 bedridden patients with a Clinical Frailty Score of ≥7 were excluded from 29 patients with concomitant internal iliac artery embolization. Intraoperative changes in the rSO2 and postoperative incidence of buttock claudication were compared, and an assessment was performed to determine if changes in rSO2 are predictive of buttock claudication. Furthermore, the presence or absence of communication between the superior and inferior gluteal arteries, as well as the intraoperative changes in rSO2, were compared, and analysis was performed to determine whether the change in blood flow to the gluteal muscles at the site of embolization of the internal iliac artery was I n cases of abdominal aortic aneurysms, it is common for the lesion to extend into the iliac artery and form a series of aneurysms. Unilateral and bilateral iliac aneurysms are associated with 40% of abdominal aortic aneurysm cases. 1-3 Endovascular aneurysm repair (EVAR) for such cases requires internal iliac artery embolization to prevent type II endoleak from the internal iliac artery. Although it has been reported that pelvic visceral ischemia and buttock claudication may occur even with unilateral embolization of the internal iliac artery, there is no method of intraoperative blood flow assessment of the internal iliac artery system. 4-6 Previous studies reported that muscle oxygenation and blood flow to regions including the gluteal muscle could be successfully evaluated using near-infrared spectroscopy (NIRS), which enables the comparison of subjects with different adipose tissue thicknesses by physiological calibration. 7,8 The purpose of this study was to evaluate the usefulness of NIRS for monitoring the regional oxygen saturation (rSO2) of gluteal artery blood flow during EVAR by com-Editorial p ????

Internal Iliac Artery Embolization within EVAR Procedure: Safety, Feasibility, and Outcome

“…The main objective of this study was to determine the actual feasibility of embolization of the IIA and to consider the presence of EL as a yardstick. Different mechanical devices [2,[11][12][13][14] or embolic agents [8,15,16] were previously described in IIAs embolization. Our results showed that 87.75% of patients could undergo the embolization of IIA without showing EL in fluoroscopy at the end of the procedure.…”