Midterm results of endovascular stented grafts for the treatment of isolated iliac artery aneurysms

Purpose: Isolated aneurysms of the iliac arteries are uncommon lesions that require surgical repair to prevent rupture. Methods: During a 4-year period, we used endovascular stented grafts (EGs) to treat 28 iliac artery aneurysms that were not associated with aortic ane urysms. Twenty-five patients, with a total of 24 common iliac (15 right, ni ne left) and four internal iliac (two right, two left) artery aneurysms, un derwent endovascular grafting. There were 24 men and 1 woman, with a mean a ge of 74 years (range, 51 to 88 years). Combined common and internal iliac artery aneurysms were present in three patients. Nineteen patients who unde rwent treatment with EGs were administered epidural anesthesia (22 epidural , two local, one general). Before surgery, one patient had lower extremity embolization and ischemia from the aneurysm, three had abdominal or back pa in, and the remaining were asymptomatic. The EGs were constructed of polyte trafluoroethylene grafts and balloon expandable stents. Results: Pour procedure-related complications (12%) occurred (distal extrem ity embolization, n = 1; wound complications, n = 2; colonic mucosal ischem ia, n = 1). Only a minimal reduction in the aneurysmal diameter was seen in 90% of the iliac artery aneurysms treated. The remaining lesions showed no change in size, and no aneurysm had an increase in cross-sectional diamete r on computed tomographic images enduring a follow-up period up to 4 years (mean, 24 months). One aneurysm ruptured after successful endovascular excl usion, and the patient underwent treatment with open repair. The 3-year pri mary patency rate of iliac EGs was 86%. Conclusion: EGs appear to show satisfactory safety and efficacy for the rep air of isolated aneurysms of the iliac arteries.