Open vs. endovascular repair of isolated iliac artery aneurysms: A 12-year experience

Niyant V. Patel, Graham W. Long, Zulfiqar Cheema, Kalen Rimar, O. William Brown, Charles J. Shanley

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Objective: To examine contemporary operative techniques and outcomes for repair of isolated iliac artery aneurysms. Methods: We retrospectively reviewed the charts of all patients who underwent repair of an isolated iliac artery aneurysm from February 1995 to June 2007. Mycotic aneurysms and patients with concurrent infrarenal abdominal aortic aneurysms greater than 3.5 cm in diameter were excluded from analysis. Patients with prior abdominal aortic aneurysm repair were not excluded. Results: Fifty-six patients (96% male; mean age, 72 ± 10 years) had either open (n = 24) or endovascular (n = 32) repair with median follow-up of 36 months. Seven patients were treated for rupture, six with open repair, and one with an endograft. Average aneurysm size for patients in the open and endovascular repair cohorts was 4.5 ± 2.4 cm and 4.0 ± 1.1 cm, respectively (P = .35). One episode of endograft limb thrombosis at five months was treated with catheter-directed thrombolytic therapy and stent placement. Thirty-day mortality for patients undergoing elective and emergent open repair was 1/18 (6%) and 1/6 (17%), respectively. There was no 30-day mortality for the endovascular group. Median length of stay was 10.5 days in the open group and one day in the endovascular elective group (P < .01). There was no mid-term aneurysm-related mortality in either group. Primary patency rates were similar between the open and endovascular groups at five years (100% vs. 96%, P = .07). Aneurysm sac diameter decreased in 67% (21/28) of patients that underwent endovascular repair. One patient with a Type III endoleak required relining of the endograft with a second endograft at 72 months. Conclusion: These data demonstrate that in appropriately selected patients, endovascular repair of isolated iliac artery aneurysms is a safe, effective alternative to open repair with mid-term follow-up. Endovascular repair is associated with a significantly reduced hospital length of stay and may be associated with decreased need for transfusion and mortality when compared with open repair.

Original languageEnglish (US)
Pages (from-to)1147-1153
Number of pages7
JournalJournal of Vascular Surgery
Volume49
Issue number5
DOIs
StatePublished - May 2009
Externally publishedYes

Fingerprint

Iliac Aneurysm
compound A 12
Iliac Artery
Aneurysm
Length of Stay
Mortality
Abdominal Aortic Aneurysm
Infected Aneurysm
Endoleak
Thrombolytic Therapy
Stents
Rupture
Thrombosis
Catheters
Extremities

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Patel, N. V., Long, G. W., Cheema, Z., Rimar, K., Brown, O. W., & Shanley, C. J. (2009). Open vs. endovascular repair of isolated iliac artery aneurysms: A 12-year experience. Journal of Vascular Surgery, 49(5), 1147-1153. https://doi.org/10.1016/j.jvs.2008.11.101

Open vs. endovascular repair of isolated iliac artery aneurysms : A 12-year experience. / Patel, Niyant V.; Long, Graham W.; Cheema, Zulfiqar; Rimar, Kalen; Brown, O. William; Shanley, Charles J.

In: Journal of Vascular Surgery, Vol. 49, No. 5, 05.2009, p. 1147-1153.

Research output: Contribution to journalArticle

Patel, NV, Long, GW, Cheema, Z, Rimar, K, Brown, OW & Shanley, CJ 2009, 'Open vs. endovascular repair of isolated iliac artery aneurysms: A 12-year experience', Journal of Vascular Surgery, vol. 49, no. 5, pp. 1147-1153. https://doi.org/10.1016/j.jvs.2008.11.101
Patel, Niyant V. ; Long, Graham W. ; Cheema, Zulfiqar ; Rimar, Kalen ; Brown, O. William ; Shanley, Charles J. / Open vs. endovascular repair of isolated iliac artery aneurysms : A 12-year experience. In: Journal of Vascular Surgery. 2009 ; Vol. 49, No. 5. pp. 1147-1153.
@article{bd1101c24fe44cc7a56895ff55cccdae,
title = "Open vs. endovascular repair of isolated iliac artery aneurysms: A 12-year experience",
abstract = "Objective: To examine contemporary operative techniques and outcomes for repair of isolated iliac artery aneurysms. Methods: We retrospectively reviewed the charts of all patients who underwent repair of an isolated iliac artery aneurysm from February 1995 to June 2007. Mycotic aneurysms and patients with concurrent infrarenal abdominal aortic aneurysms greater than 3.5 cm in diameter were excluded from analysis. Patients with prior abdominal aortic aneurysm repair were not excluded. Results: Fifty-six patients (96{\%} male; mean age, 72 ± 10 years) had either open (n = 24) or endovascular (n = 32) repair with median follow-up of 36 months. Seven patients were treated for rupture, six with open repair, and one with an endograft. Average aneurysm size for patients in the open and endovascular repair cohorts was 4.5 ± 2.4 cm and 4.0 ± 1.1 cm, respectively (P = .35). One episode of endograft limb thrombosis at five months was treated with catheter-directed thrombolytic therapy and stent placement. Thirty-day mortality for patients undergoing elective and emergent open repair was 1/18 (6{\%}) and 1/6 (17{\%}), respectively. There was no 30-day mortality for the endovascular group. Median length of stay was 10.5 days in the open group and one day in the endovascular elective group (P < .01). There was no mid-term aneurysm-related mortality in either group. Primary patency rates were similar between the open and endovascular groups at five years (100{\%} vs. 96{\%}, P = .07). Aneurysm sac diameter decreased in 67{\%} (21/28) of patients that underwent endovascular repair. One patient with a Type III endoleak required relining of the endograft with a second endograft at 72 months. Conclusion: These data demonstrate that in appropriately selected patients, endovascular repair of isolated iliac artery aneurysms is a safe, effective alternative to open repair with mid-term follow-up. Endovascular repair is associated with a significantly reduced hospital length of stay and may be associated with decreased need for transfusion and mortality when compared with open repair.",
author = "Patel, {Niyant V.} and Long, {Graham W.} and Zulfiqar Cheema and Kalen Rimar and Brown, {O. William} and Shanley, {Charles J.}",
year = "2009",
month = "5",
doi = "10.1016/j.jvs.2008.11.101",
language = "English (US)",
volume = "49",
pages = "1147--1153",
journal = "Journal of Vascular Surgery",
issn = "0741-5214",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Open vs. endovascular repair of isolated iliac artery aneurysms

T2 - A 12-year experience

AU - Patel, Niyant V.

AU - Long, Graham W.

AU - Cheema, Zulfiqar

AU - Rimar, Kalen

AU - Brown, O. William

AU - Shanley, Charles J.

PY - 2009/5

Y1 - 2009/5

N2 - Objective: To examine contemporary operative techniques and outcomes for repair of isolated iliac artery aneurysms. Methods: We retrospectively reviewed the charts of all patients who underwent repair of an isolated iliac artery aneurysm from February 1995 to June 2007. Mycotic aneurysms and patients with concurrent infrarenal abdominal aortic aneurysms greater than 3.5 cm in diameter were excluded from analysis. Patients with prior abdominal aortic aneurysm repair were not excluded. Results: Fifty-six patients (96% male; mean age, 72 ± 10 years) had either open (n = 24) or endovascular (n = 32) repair with median follow-up of 36 months. Seven patients were treated for rupture, six with open repair, and one with an endograft. Average aneurysm size for patients in the open and endovascular repair cohorts was 4.5 ± 2.4 cm and 4.0 ± 1.1 cm, respectively (P = .35). One episode of endograft limb thrombosis at five months was treated with catheter-directed thrombolytic therapy and stent placement. Thirty-day mortality for patients undergoing elective and emergent open repair was 1/18 (6%) and 1/6 (17%), respectively. There was no 30-day mortality for the endovascular group. Median length of stay was 10.5 days in the open group and one day in the endovascular elective group (P < .01). There was no mid-term aneurysm-related mortality in either group. Primary patency rates were similar between the open and endovascular groups at five years (100% vs. 96%, P = .07). Aneurysm sac diameter decreased in 67% (21/28) of patients that underwent endovascular repair. One patient with a Type III endoleak required relining of the endograft with a second endograft at 72 months. Conclusion: These data demonstrate that in appropriately selected patients, endovascular repair of isolated iliac artery aneurysms is a safe, effective alternative to open repair with mid-term follow-up. Endovascular repair is associated with a significantly reduced hospital length of stay and may be associated with decreased need for transfusion and mortality when compared with open repair.

AB - Objective: To examine contemporary operative techniques and outcomes for repair of isolated iliac artery aneurysms. Methods: We retrospectively reviewed the charts of all patients who underwent repair of an isolated iliac artery aneurysm from February 1995 to June 2007. Mycotic aneurysms and patients with concurrent infrarenal abdominal aortic aneurysms greater than 3.5 cm in diameter were excluded from analysis. Patients with prior abdominal aortic aneurysm repair were not excluded. Results: Fifty-six patients (96% male; mean age, 72 ± 10 years) had either open (n = 24) or endovascular (n = 32) repair with median follow-up of 36 months. Seven patients were treated for rupture, six with open repair, and one with an endograft. Average aneurysm size for patients in the open and endovascular repair cohorts was 4.5 ± 2.4 cm and 4.0 ± 1.1 cm, respectively (P = .35). One episode of endograft limb thrombosis at five months was treated with catheter-directed thrombolytic therapy and stent placement. Thirty-day mortality for patients undergoing elective and emergent open repair was 1/18 (6%) and 1/6 (17%), respectively. There was no 30-day mortality for the endovascular group. Median length of stay was 10.5 days in the open group and one day in the endovascular elective group (P < .01). There was no mid-term aneurysm-related mortality in either group. Primary patency rates were similar between the open and endovascular groups at five years (100% vs. 96%, P = .07). Aneurysm sac diameter decreased in 67% (21/28) of patients that underwent endovascular repair. One patient with a Type III endoleak required relining of the endograft with a second endograft at 72 months. Conclusion: These data demonstrate that in appropriately selected patients, endovascular repair of isolated iliac artery aneurysms is a safe, effective alternative to open repair with mid-term follow-up. Endovascular repair is associated with a significantly reduced hospital length of stay and may be associated with decreased need for transfusion and mortality when compared with open repair.

UR - http://www.scopus.com/inward/record.url?scp=64949083552&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=64949083552&partnerID=8YFLogxK

U2 - 10.1016/j.jvs.2008.11.101

DO - 10.1016/j.jvs.2008.11.101

M3 - Article

C2 - 19237261

AN - SCOPUS:64949083552

VL - 49

SP - 1147

EP - 1153

JO - Journal of Vascular Surgery

JF - Journal of Vascular Surgery

SN - 0741-5214

IS - 5

ER -