Midterm experience with the endovascular treatment of isolated iliac aneurysms

Purpose: This report describes our 5-year experience with the endovascular repair of isolated iliac aneurysms and pseudoaneurysms. Methods: Between June 1993 and July 1998, 40 isolated iliac aneurysms and p seudoaneurysms were treated with endovascular grafts in 39 patients. Thirty -seven aneurysms were treated with endovascular grafts composed of polytetr afluoroethylene grafts and balloon expandable stents, and the other three u nderwent repair with a polycarbonate urethane endoluminal graft. Results: All the patients under went initially successful endovascular trea tment of isolated iliac aneurysms and pseudoaneurysms and were followed fro m 1 to 51 months (mean, 18 months). The 4-year primary patency rate was 94. 5% +/- 10%. The perioperative complications included one episode of distal embolization, an episode of colonic ischemia, five episodes of kinking or c ompression of the endovascular graft, and one early postoperative graft thr ombosis. There was only one perioperative death in a patient whose aneurysm ruptured in the operating room just before endovascular repair. The median postoperative length of hospital stay was 3.0 +/- 1.3 days in this group o f patients at moderate and high risk. The long-term complications included one graft thrombosis and two endoleaks. One small endoleak was followed unt il the patient died of unrelated causes, and the other one led to aneurysm rupture in the only patient temporarily lost to follow-up examination. This patient successfully underwent treatment in the standard open surgical fas hion. To date, all the other aneurysms have remained stable or have decreas ed in sire during the follow-up examinations with duplex or contrast-enhanc ed computed tomographic scans. Conclusion: Endovascular repair of iliac aneurysms and pseudoaneurysms is a safe and effective technique with good midterm results in patients at stan dard and high risk. These grafts are particularly beneficial for patients w ith medical, surgical, or anatomic contraindications for open surgical repa ir.