2018
DOI: 10.23736/s0392-9590.18.04004-x
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Internal iliac artery preservation strategies in the endovascular treatment of aortoiliac aneurysms

Abstract: INTRODUCTION: Common iliac aneurysms are present in up to 40% of abdominal aortic aneurysms and frequently impair distal landing zones for endovascular aneurysm repair. Several techniques have been developed in order to overcome these issues, with different applications and conflicting results. Although long-term outcomes of hypogastric exclusion are favorable, the risks of pelvic ischemia and morbidity rates are high. We aim to review current hypogastric preservation strategies used in the endovascular treatm… Show more

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Cited by 14 publications
(3 citation statements)
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“…Bell-bottom technique, although apparently effective in the short term, has a questionable long-term durability, with type 1b endoleak rating between 3.4 and 7.8% and with a high rate of reinterventions. 16 Provided that, sometimes, CIA does not allow a durable sealing in EVAR, it turns necessary to extend the landing zone into the external iliac artery, which implies preserving hypogastric vessels. Current ESVS guidelines recommend the use of IBE in anatomically suitable patients to maintain perfusion of at least one IIA.…”
Section: Discussionmentioning
confidence: 99%
“…Bell-bottom technique, although apparently effective in the short term, has a questionable long-term durability, with type 1b endoleak rating between 3.4 and 7.8% and with a high rate of reinterventions. 16 Provided that, sometimes, CIA does not allow a durable sealing in EVAR, it turns necessary to extend the landing zone into the external iliac artery, which implies preserving hypogastric vessels. Current ESVS guidelines recommend the use of IBE in anatomically suitable patients to maintain perfusion of at least one IIA.…”
Section: Discussionmentioning
confidence: 99%
“…Specifically, if the distal common iliac artery (CIA) does not present an adequate healthy landing zone, exclusion of internal iliac artery (IIA) or hypogastric artery is often required. Though benefits of preserving IIAs are now well-acknowledged and different strategies, devices, such as iliac branch device (IBD), are developed ( 7 ). Nevertheless, such techniques would significantly increase the surgery time and complexity and could be limited by anatomical constraints, technique experience, and availability of grafts.…”
Section: Introductionmentioning
confidence: 99%
“…Complexity of the pelvic vascular systems highlights the importance of a good understanding of retroperitoneal anatomy and its possible variations. Such knowledge proves invaluable to surgeons and clinicians, especially urologists [12], gynaecologists, obstetricians [13], and general surgeons [14,15]. There is pressing need for accurate descriptions of pelvic vascularization in laparoscopic surgery, in order to prevent iatrogenic damages [16].…”
Section: Discussionmentioning
confidence: 99%