Annals of vascular surgery · 2025
Short- and Mid-Term Results of Reconstruction of Internal Iliac Artery in Abdominal Aorto-Iliac Artery Aneurysm Endovascular Repair Using Off-the-Shelf and Physician-Modified Iliac Branch Devices.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Xie Yiyun, Zhang Tianjing, Li Kang, Kong Deqiang, Xie Lizhi, Lai Zhichao, Ni Leng, Ye Wei, Zheng Yuehong, Shao Jiang, Liu Bao
Аннотация
BACKGROUND: This study compares short- and mid-term outcomes of off-the-shelf iliac-branched devices (OTS-IBDs) and physician-modified iliac branch devices (PM-IBDs) for internal iliac artery (IIA) reconstruction in endovascular repair of abdominal aorto-iliac artery aneurysms.
METHODS: A retrospective, single-center cohort study was conducted, including patients with abdominal aorto-iliac artery aneurysms, and underwent endovascular repair using PM-IBDs or OTS-IBDs from January 2021 to December 2023. The primary outcome was ipsilateral adverse iliac events (AIEs), including type Ib, Ic, and III endoleaks, symptomatic dissection or occlusion, and other clinical events requiring re-intervention. Secondary outcomes were technical success, re-intervention, and clinical success.
RESULTS: Of total 76 patients were included, of which 50 patients accepted OTS-IBD and 26 patients accepted PM-IBD. Technical success was 100% in both groups. Clinical success rates at 12 months were comparable (OTS-IBD: 95.6%; PM-IBD: 87.8%; log-rank P = 0.62). AIEs occurred in 8.0% (4/50) of OTS-IBD and 9.4% (3/32) of PM-IBD cases (P = 0.828), with freedom from AIE rates of 91.8% and 85.0% (log rank P = 0.850). Only one patient in PM-IBD group experienced re-intervention for treatment of AIE, which was acute occlusion in iliac limb of IBD. PM-IBD procedures required significantly longer operative times (OTS-IBD: 198.2 ± 62.4 min versus PM-IBD: 335.6 ± 127.6 min, P < 0.001) and showed trends toward more access-related hemorrhagic events (OTS-IBD: 1/46, 2.2% vs. PM-IBD: 4/30, 13.3%, P = 0.055). No significant differences were observed in perioperative mortality, major complications, or primary branch patency (OTS-IBD: 100.0% vs. PM-IBD, 96.7%; P = 0.209). Postoperative blood tests indicated prolonged prothrombin time (OTS-IBD: 12.3 ± 1.0 s vs. PM-IBD: 16.0 ± 18.9 s, P = 0.048) and lower fibrinogen levels (OTS-IBD: 2.96 ± 0.62 g/L vs. PM-IBD:2.67 ± 0.60 g/L, P = 0.087) in the PM-IBD group.
CONCLUSION: Both PM-IBD and OTS-IBD were safe and effective in IIA reconstruction in endovascular repair of abdominal aorto-iliac artery aneurysms.
METHODS: A retrospective, single-center cohort study was conducted, including patients with abdominal aorto-iliac artery aneurysms, and underwent endovascular repair using PM-IBDs or OTS-IBDs from January 2021 to December 2023. The primary outcome was ipsilateral adverse iliac events (AIEs), including type Ib, Ic, and III endoleaks, symptomatic dissection or occlusion, and other clinical events requiring re-intervention. Secondary outcomes were technical success, re-intervention, and clinical success.
RESULTS: Of total 76 patients were included, of which 50 patients accepted OTS-IBD and 26 patients accepted PM-IBD. Technical success was 100% in both groups. Clinical success rates at 12 months were comparable (OTS-IBD: 95.6%; PM-IBD: 87.8%; log-rank P = 0.62). AIEs occurred in 8.0% (4/50) of OTS-IBD and 9.4% (3/32) of PM-IBD cases (P = 0.828), with freedom from AIE rates of 91.8% and 85.0% (log rank P = 0.850). Only one patient in PM-IBD group experienced re-intervention for treatment of AIE, which was acute occlusion in iliac limb of IBD. PM-IBD procedures required significantly longer operative times (OTS-IBD: 198.2 ± 62.4 min versus PM-IBD: 335.6 ± 127.6 min, P < 0.001) and showed trends toward more access-related hemorrhagic events (OTS-IBD: 1/46, 2.2% vs. PM-IBD: 4/30, 13.3%, P = 0.055). No significant differences were observed in perioperative mortality, major complications, or primary branch patency (OTS-IBD: 100.0% vs. PM-IBD, 96.7%; P = 0.209). Postoperative blood tests indicated prolonged prothrombin time (OTS-IBD: 12.3 ± 1.0 s vs. PM-IBD: 16.0 ± 18.9 s, P = 0.048) and lower fibrinogen levels (OTS-IBD: 2.96 ± 0.62 g/L vs. PM-IBD:2.67 ± 0.60 g/L, P = 0.087) in the PM-IBD group.
CONCLUSION: Both PM-IBD and OTS-IBD were safe and effective in IIA reconstruction in endovascular repair of abdominal aorto-iliac artery aneurysms.