복부대동맥류의 혈관 내 치료 시 내장골동맥 색전술의 유용성 (Effectiveness of Embolization of Internal Iliac Artery during Endovascular Aneurysm Repair)

초록

Purpose: Embolization of the internal iliac artery (IIA) is frequently required during endovascular aneurysm repair (EVAR) because of a concurrent common iliac artery aneurysm, a short common iliac artery, or deployment of aortouni-iliac devices. This study was conducted to evaluate the effectiveness of IIA embolization during EVAR.
Methods: A retrospective study was performed in patients undergoing EVAR and IIA embolization from December 2005 to March 2011 from a prospectively registered database of patients with aneurysms. Patient clinical characteristics, procedures, and follow up data were collected and analyzed.
Results: Eighteen patients (33.3%) required IIA embolization among 54 EVARs. The mean age was 73.5years, and 17 patients were male. Indications were a common iliac artery aneurysm (11/18), short iliac artery (3/18), thrombosed common iliac artery (1/18), arteriovenous malformation (1/18), and deployment of aortouniiliac artery devices (1/18). One mortality occurred in a patient with a ruptured abdominal aortic aneurysm. No type I endoleaks were observed. IIA embolization was achieved with conventional coils (7/18),a vascular plug (6/18), and detachable coils (5/18). After EVAR, there were two cases of ileus, a limb occlusion that required additional stenting in the external iliac artery, a type II endoleak, and two cases of buttock claudication.
Conclusion: IIA embolization during EVAR is effective to prevent a type II endoleak with minor morbidities.

영어초록

Purpose: Embolization of the internal iliac artery (IIA) is frequently required during endovascular aneurysm repair (EVAR) because of a concurrent common iliac artery aneurysm, a short common iliac artery, or deployment of aortouni-iliac devices. This study was conducted to evaluate the effectiveness of IIA embolization during EVAR.
Methods: A retrospective study was performed in patients undergoing EVAR and IIA embolization from December 2005 to March 2011 from a prospectively registered database of patients with aneurysms. Patient clinical characteristics, procedures, and follow up data were collected and analyzed.
Results: Eighteen patients (33.3%) required IIA embolization among 54 EVARs. The mean age was 73.5years, and 17 patients were male. Indications were a common iliac artery aneurysm (11/18), short iliac artery (3/18), thrombosed common iliac artery (1/18), arteriovenous malformation (1/18), and deployment of aortouniiliac artery devices (1/18). One mortality occurred in a patient with a ruptured abdominal aortic aneurysm. No type I endoleaks were observed. IIA embolization was achieved with conventional coils (7/18),a vascular plug (6/18), and detachable coils (5/18). After EVAR, there were two cases of ileus, a limb occlusion that required additional stenting in the external iliac artery, a type II endoleak, and two cases of buttock claudication.
Conclusion: IIA embolization during EVAR is effective to prevent a type II endoleak with minor morbidities.

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