Mid-term outcomes of different treatments of internal iliac artery in endovascular aneurysm repair

IF 2.6 4区 综合性期刊 Q2 MULTIDISCIPLINARY SCIENCES Science Progress Pub Date : 2024-09-10 DOI:10.1177/00368504241274998
Jie Ji, Jiaxue Bi, Yonghui Chen, Xiaoxing Zhang, Bin Zhao, Hao Liang, Jibo Fan, Xiangchen Dai
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Abstract

ObjectiveTo evaluate the mid-term outcomes of different treatment strategies for the internal iliac artery (IIA) during EVAR.MethodsThis was a retrospective study. All patients undergoing EVAR, who required treatment of at least one side of IIA from January 2013 to July 2022 in a single center, were included. According to the different treatment strategies for IIA, the patients were divided into UP (unilateral preservation), BP (bilateral preservation) and BE (bilateral embolization) groups. The primary outcomes included buttock claudication, bowel ischemia and iliac-related reintervention. Then patients who underwent IIA reconstruction were divided into IPG (iliac parallel stent graft) and IBG (iliac branch stent graft) groups according to the reconstruction technique. The primary outcomes included endoleak, iliac branch occlusion and iliac-related reintervention.ResultsA total of 237 patients were included, including 167 in the UP group, 9 in the BP group and 61 in the BE group. The mean follow-up time was 39.0 ± 27.7, 50.0 ± 22.1 and 25.8 ± 18.9 months in UP, BP and BE groups, respectively. Thirty cases (12.7%) of buttock claudication occurred, and it was significantly higher in the BE group than the UP group (26.2% vs. 7.8%, p < 0.001). There were no significant differences in the other follow-up outcomes among three groups. The K–M analysis indicated that the patients in the BE group had a lower survival rate than those in the other two groups (p = 0.024). 24 patients underwent IIA reconstruction, including 8 in the IPG group and 16 in the IBG group. The endoleak in the IBG group was significantly lower than that in the IPG group (0% vs. 25.0%, p = 0.041). The iliac-related reintervention, iliac occlusion and mortality were similar between the two groups.ConclusionOverall it is beneficial for patients to preserve at least one side of IIA during EVAR as much as possible. Compared with IPG, IBG might be more applicable for IIA reconstruction.
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血管内动脉瘤修补术中髂内动脉不同治疗方法的中期疗效
目的 评价 EVAR 期间髂内动脉(IIA)不同治疗策略的中期疗效。纳入2013年1月至2022年7月在一个中心接受EVAR手术的所有患者,这些患者至少需要治疗一侧髂内动脉。根据IIA的不同治疗策略,患者被分为UP(单侧保留)组、BP(双侧保留)组和BE(双侧栓塞)组。主要结果包括臀部跛行、肠缺血和髂骨相关再介入。然后,根据重建技术将接受IIA重建的患者分为IPG(髂平行支架移植)组和IBG(髂支支架移植)组。结果 共纳入 237 例患者,其中 UP 组 167 例,BP 组 9 例,BE 组 61 例。UP组、BP组和BE组的平均随访时间分别为(39.0 ± 27.7)、(50.0 ± 22.1)和(25.8 ± 18.9)个月。发生臀部跛行的病例有 30 例(12.7%),BE 组明显高于 UP 组(26.2% 对 7.8%,P < 0.001)。三组患者的其他随访结果无明显差异。K-M分析表明,BE组患者的存活率低于其他两组(P = 0.024)。24 名患者接受了 IIA 重建,其中 IPG 组 8 人,IBG 组 16 人。IBG 组的内漏率显着低于 IPG 组(0% 对 25.0%,P = 0.041)。两组患者的髂骨相关再介入、髂骨闭塞和死亡率相似。与 IPG 相比,IBG 可能更适用于 IIA 重建。
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来源期刊
Science Progress
Science Progress Multidisciplinary-Multidisciplinary
CiteScore
3.80
自引率
0.00%
发文量
119
期刊介绍: Science Progress has for over 100 years been a highly regarded review publication in science, technology and medicine. Its objective is to excite the readers'' interest in areas with which they may not be fully familiar but which could facilitate their interest, or even activity, in a cognate field.
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