Clinical implications of internal iliac artery embolization in endovascular repair of aortoiliac aneurysms

To overcome constraints imposed by iliac artery anatomy, the anatomic inclu sion criteria for endovascular aortic aneurysm repair can be extended by me ans of intentional coil occlusion of one or both internal iliac arteries an d extension of the distal limb of the graft into an external iliac artery. We reviewed our experience with this intervention to determine the safety a nd efficacy of this approach to aneurysm repair. Over a 30-month period, 84 patients underwent endovascular abdominal aortic aneurysm repair; 23 under went intentional unilateral (22) or bilateral (1) internal iliac artery occ lusion. Morbidity, mortality, and long-term clinical outcomes were evaluate d in these 23 patients. Patients were specifically questioned about exercis e-induced buttock and extremity symptoms. Our results showed that intention al internal iliac artery embolization to allow endovascular repair of abdom inal aortic aneurysms is accompanied by significant morbidity and should be approached with caution.