Isolated Common Iliac Artery Aneurysms:A Revised Classification to Assist Endovascular Repair

Abstract

Isolated common iliac artery aneurysms (CIAAs) are relatively rare; they typically progress asymptomatically and are revealed incidentally, usually after they have acquired significant dimensions. Traditional open reconstruction is associated with high morbidity and mortality rates. Rupture is a common initial manifestation. Endovascular repair has been proposed as a minimally invasive alternative, associated with lower morbidity and mortality rates, even in patients at high surgical risk; some specialists have recently proposed endoluminal repair as the first-choice procedure in suitable anatomies. However, only a few sporadic attempts have been made to define the "suitable" anatomy for endovascular repair. This article proposes a classification of isolated CIAAs and provides endovascular specialists with a guide to deciding which type of repair is feasible and efficacious according to the anatomical configuration of the aneurysm.

Inferior Mesentery Artery and Internal Iliac Artery Preservation with Covered Self-Expanding Stents during Endovascular Aneurysm Repair

“…Isolated CIAAs usually progress asymptomatically and are revealed incidentally following abdominal imaging. Rupture is a common initial manifestation that also produces substantial mortality [3]. …”

“…Engelke et al [5] reported that unilateral IIA convergence might cause benign symptoms with a 25% incidence of buttock claudication, but bilateral IIA occlusion should generally be avoided [3]. Kim et al [6] reported a rare case of ischemic colitis with bilaterally patent IIAs after endovascular abdominal aneurysm repair.…”

Novel-Designed Iliac Branch Stent Graft for Internal Iliac Artery Reconstruction during Aneurysm Repair

“…1,2 A total of 70e90% of the iliac aneurysms occur in common iliac arteries (CIAs), with internal iliac arteries (IIAs) involvement in 10e30% of the cases, which makes endovascular aneurysm repair more complicated. 3 Current open or endovascular treatments of iliac aneurysms often sacrifice IIA, which may result in buttock or thigh claudication, erectile dysfunction, ischemic colitis, gluteal or perineal necrosis, spinal cord injury, and acute limb ischemia. 4e10 To address these issues, various technologies of IIA reconstruction in the treatment of iliac aneurysms have been reported.…”

When the chimney is blocked: malignant renovascular hypertension after endovascular repair of abdominal aortic aneurysm

“…Contrary to EVAR with the fenestrated or branched technique, the CG technique involves standard off-the-shelf stent grafts and can be used in emergent cases [1,2]. Possible indications for the use of CGs, other than treating suprarenal and juxtarenal abdominal aortic aneurysms, include thoracic and thoracoabdominal aneurysms with supraortic branches orifice involvement and suitable cases of common iliac artery aneurysms with or without internal iliac artery involvement [7,8]. A potential major drawback of the EVAR procedures is the presence of endoleaks ( i .…”