Treatment of iliac artery aneurysms by percutaneous implantation of stent grafts

Background-Iliac artery aneurysms have traditionally been treated by direct surgical reconstruction. Endovascular stent grafts have been developed to provide an effective but less invasive treatment option for patients with p eripheral arterial aneurysms. Methods and Results-In 48 patients, a total of 53 endoprostheses (mean leng th 7,3 cm, mean diameter 8.1 mm) were implanted into the iliac arteries (co mmon iliac artery n=29, external iliac artery n=19) for percutaneous exclus ion of aneurysmal lesions. The technical success of complete exclusion of t he aneurysm was achieved in 47 of 48 cases (97.9%). In I case, persistent p erfusion through a collateral branch was detected; however, this aneurysm t hrombosed spontaneously within weeks. In all patients, graft patency was mo nitored by clinical examination, which included the standardized treadmill test with calculation of the ankle-brachial Doppler index and color-coded d uplex ultrasound. Forty-two of the 48 patients (87.5%) underwent follow-up angiography. According to Kaplan-Meier life-table calculations, primary pat ency rates were 100% after 1 year, 97.9% after 2 years, 94.9% after 3 years , and 87.6% after 4 years. Serial contrast-enhanced spiral CT scans were pe rformed to rule out late procedural failures and to assess growth progressi on of the lesions. No secondary leaks were observed. Furthermore, the aneur ysm diameter had reduced from 24.8+/-8.0 mm to 23.1+/-6.6 mm at the last fo llow-up (P=NS). Conclusions-Stent grafts are a safe and effective treatment option for ilia c artery aneurysms and provide good long-term patency of the graft.