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2. Endovascular aortic repair with EndoAnchors demonstrate good mid-term outcomes in physician-initiated multicenter analysis—The PERU registry

Author

Reyes Valdivia, Andrés, primary, Chaudhuri, Arindam, additional, Milner, Ross, additional, Pratesi, Giovanni, additional, Reijnen, Michel MPJ, additional, Tinelli, Giovanni, additional, Schuurmann, Richte, additional, Barbante, Matteo, additional, Babrowski, Trissa A, additional, Pitoulias, Georgios, additional, Tshomba, Yamume, additional, Gandarias, Claudio, additional, Badawy, Ayman, additional, and de Vries, Jean-Paul PM, additional

Published
2021
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5. Iliac Branch Devices With Standard vs Fenestrated/Branched Stent-Grafts: Does Aneurysm Complexity Produce Worse Outcomes? Insights From the pELVIS Registry

Author

Spanos, Konstantinos, primary, Kölbel, Tilo, additional, Scheerbaum, Martin, additional, Donas, Konstantinos P., additional, Austermann, Martin, additional, Rohlffs, Fiona, additional, Verzini, Fabio, additional, Tsilimparis, Nikolaos, additional, Bosiers, Michel, additional, Inchingolo, Mirjam, additional, Torsello, Giovanni, additional, Weiss, Kristin, additional, Branzan, Daniela, additional, Scheinert, Dirk, additional, Schmidt, Andrej, additional, Haulon, Stéphan, additional, Pitoulias, Georgios A., additional, Parlani, Gianbattista, additional, Simonte, Gioele, additional, Dorigo, Walter, additional, Fargion, Aaron, additional, Masciello, Fabrizio, additional, Pratesi, Carlo, additional, Vergata, Tor, additional, Barbante, Matteo, additional, Ippoliti, Arnaldo, additional, Pratesi, Giovanni, additional, Forlanini, San Camillo, additional, Cao, Piergiorgio, additional, and Ferrer, Ciro, additional

Published
2020
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6. Late outcomes of different hypogastric stent grafts in aortoiliac endografting with iliac branch device: Results from the pELVIS Registry

Author

Verzini, Fabio, primary, Parlani, Gianbattista, additional, Varetto, Gianfranco, additional, Gibello, Lorenzo, additional, Boero, Michele, additional, Torsello, Giovanni Federico, additional, Donas, Konstantinos P., additional, Simonte, Gioele, additional, Austermann, Martin, additional, Inchingolo, Mirjam, additional, Bisdas, Theodosios, additional, Torsello, Giovanni, additional, Pratesi, Giovanni, additional, Barbante, Matteo, additional, Cao, Piergiorgio, additional, Ferrer, Ciro, additional, Pratesi, Carlo, additional, Fargion, Aaron, additional, Masciello, Fabrizio, additional, Kölbel, Tilo, additional, Tsilimparis, Nikolaos, additional, Haulon, Stephan, additional, Branzan, Daniela, additional, Schmidt, Andrej, additional, and Scheinert, Dirk, additional

Published
2020
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7. Results of Iliac Branch Devices in Octogenarians Within the pELVIS Registry

Author

Fargion, Aaron Thomas, primary, Masciello, Fabrizio, additional, Pratesi, Giovanni, additional, Torsello, Giovanni, additional, Donas, Konstantinos P., additional, Pratesi, Carlo, additional, Austermann, Martin, additional, Inchingolo, Mirjam, additional, Bisdas, Theodosios, additional, Pitoulias, Georgios A., additional, Taneva, Gergana T., additional, Dorigo, Walter, additional, Ippoliti, Arnaldo, additional, Barbante, Matteo, additional, Cao, Piergiorgio, additional, Ferrer, Ciro, additional, Verzini, Fabio, additional, Parlani, Gianbattista, additional, Simonte, Gioele, additional, Kölbel, Tilo, additional, Tsilimparis, Nikolaos, additional, Haulon, Stephan, additional, Branzan, Daniela, additional, Schmidt, Andrej, additional, and Scheinert, Dirk, additional

Published
2020
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8. Endovascular aortic repair with EndoAnchors demonstrate good mid-term outcomes in physician-initiated multicenter analysis—The PERU registry.

Author

Reyes Valdivia, Andrés, Chaudhuri, Arindam, Milner, Ross, Pratesi, Giovanni, Reijnen, Michel MPJ, Tinelli, Giovanni, Schuurmann, Richte, Barbante, Matteo, Babrowski, Trissa A, Pitoulias, Georgios, Tshomba, Yamume, Gandarias, Claudio, Badawy, Ayman, and de Vries, Jean-Paul PM

Abstract

Objectives: We aim to describe real-world outcomes from multicenter data about the efficacy of adjunct Heli-FX EndoAnchor usage in preventing or repairing failures during infrarenal endovascular aneurysm repair (EVAR), so-called EndoSutured-aneurysm-repair (ESAR). Methods: The current study has been assigned an identifier (NCT04100499) at the US National Library of Medicine (https://ClinicalTrials.gov). It is an observational retrospective study of prospectively collected data from seven vascular surgery departments between June 2010 and December 2019. Patients included in the ANCHOR registry were excluded from this analysis. The decision for the use of EndoAnchors was made by the treating surgeon or multidisciplinary aortic committee according to each center's practice. Follow-up imaging was scheduled according to each center's protocol, which necessarily included either abdominal ultrasound or radiography or computed tomographic scan imaging. The main outcomes analyzed were technical success, freedom from type Ia endoleaks (IaEL), all-cause and aneurysm-related mortality, and sac variation and trends evaluated for those with at least six months imaging follow-up. Results: Two hundred and seventy-five patients underwent ESAR in participating centers during the study period. After exclusions, 221 patients (184 males, 37 females, mean age 75 ± 8.3 years) were finally included for analysis. Median follow-up for the cohort was 27 (interquartile range 12–48) months. A median 6 (interquartile range 3) EndoAnchors were deployed at ESAR, 175 (79%) procedures were primary and 46 (21%) revision cases, 40 associated with type IaEL. Technical success at operation (initial), 30-day, and overall success were 89, 95.5, and 96.8%, respectively; the 30-day success was higher due to those with subsequent spontaneous proximal endoleak seal. At two years, freedom from type IaEL was 94% for the whole series; 96% and 86% for the primary and revision groups, respectively; whereas freedom from all-cause mortality, aneurysm-related mortality, and reintervention was 89%, 98%, and 87%, respectively. Sac evolution pre-ESAR was 66 ± 15.1 vs. post ESAR 61 ± 17.5 (p < 0.001) and for 180 patients with at least six-month follow-up, 92.2% of them being in a stable (51%) or regression (41%) situation. Conclusions: This real-world registry demonstrates that adjunct EndoAnchor usage at EVAR achieves high rates of freedom from type IaEL at mid-term including in a high number of patients with hostile neck anatomy, with positive trends in sac-size evolution. Further data with longer follow-up may help to establish EndoAnchor usage as a routine adjunct to EVAR, especially in hostile necks. [ABSTRACT FROM AUTHOR]

Published
2022
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9. Bilateral Use of Iliac Branch Devices for Aortoiliac Aneurysms Is Safe and Feasible, and Procedural Volume Does Not Seem to Affect Technical or Clinical Effectiveness: Early and Midterm Results From the pELVIS International Multicentric Registry.

Author

D'Oria, Mario, Pitoulias, Georgios A., Torsello, Giovanni F., Pitoulias, Apostolos G., Fazzini, Stefano, Masciello, Fabrizio, Verzini, Fabio, Donas, Konstantinos P., Taneva, Gergana T., Austermann, Martin, Bosiers, Michel, Dorigo, Walter, Cao, Piergiorgio, Ferrer, Ciro, Ippoliti, Arnaldo, Barbante, Matteo, Parlani, Gianbattista, Simonte, Gioele, Kölbel, Tilo, and Tsilimparis, Nikolaos

Abstract

Objective: To evaluate early and follow-up outcomes following bilateral use of iliac branch devices (IBD) for aortoiliac endografting and assess the impact of center volume. We used data from the pELVIS international multicentric registry. Methods: For the purpose of this study, only those patients receiving concomitant bilateral IBD implantation were analyzed. To assess the impact that procedural volume of bilateral IBD implantation could have on early and follow-up outcomes, participating institutions were classified as Site(s) A if they had performed >10 and/or >20% concomitant bilateral IBD procedure, otherwise they were classified as Site(s) B. Endpoints of the analysis included early (ie, 30-day) mortality and morbidity, as well as all-cause and aneurysm-related mortality during follow-up. Additional endpoints that were evaluated included IBD-related reinterventions, IBD occlusion or stenosis requiring reintervention (ie, loss of primary patency), and IBD-related type I endoleak. Results: Overall, 96 patients received bilateral IBD implantation (out of 910 procedures collected in the whole pELVIS cohort), of whom 65 were treated at Site A (ie, Group A) and 31 were treated at Site(s) B (ie, Group B). In total, only 1 death occurred within 30 days from bilateral IBD implantation, and 9 patients experienced at least 1 major complication without any significant difference between subjects in Group A versus those in Group B (10.8% vs 6.5%, p=0.714). In the overall cohort, the 2-year freedom from IBD-related type I endoleaks and IBD primary patency were 96% and 92%, respectively; no significant differences were seen in those rates between Group A or Group B (95% vs 100%, p=0.335; 93% vs 88%, p=0.470). Freedom from any IBD-related reinterventions was 83% at 2 years, with similar rates between study groups (85% vs 83%, p=0.904). Conclusions: Within the pELVIS registry, concomitant bilateral IBD implantation is a safe and feasible technique for management of aortoiliac aneurysms in patients with suitable anatomy. Despite increased technical complexity, effectiveness of the repair is satisfactory with low rates of IBD-related adverse events at mid-term follow-up. Procedural volume does not seem to affect technical or clinical outcomes after bilateral use of IBD, which remains a favorable treatment option in selected patients. [ABSTRACT FROM AUTHOR]

Published
2021
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10. comparison of aortoiliac repair with iliac branch endoprosthesis versus hypogastric occlusion in aortoiliac aneurysms

Author

Verzini, Fabio, Cieri, Enrico, Parlani, Gianbattista, Pijla, Grazia, Simonte, Gioele, De Blasis, Giovanni, Di Girolamo, Carla, Veroux, Pierfrancesco, Giaquinta, Alessia, Pratesi, Carlo, Fargion, Aaron T., Silingardi, Roberto, Farchioni, Luca, Jannello, Antonio, Garri-Boli, Luca, Fadda, Gianfranco, Marino, Mario, Parlani, Giambattista, Speziale, Francesco, Mansour, Wassim, Giudice, Rocco, Sbenaglia, Giorgio, Ippoliti, Arnaldo, Barbante, Matteo, Gaggiano, Andrea, Ferri, Michelangelo, Rispoli, Pietro, Varetto, Gian F., Ruffino, Antonella, Veraldi, Gianfranco, and Mezzetto, Luca

Subjects
medicine.medical_specialty, business.industry, aortic aneurysm, abdominal - Iliac aneurysm - Endovascular procedures, abdominal - Iliac aneurysm - Endovascular procedures, medicine.disease, Surgery, Iliac aneurysm, Aortic aneurysm, Abdominal, Endovascular procedures, Aortic aneurysm, abdominal, Occlusion, Medicine, Iliac Aneurysm, business, Cardiology and Cardiovascular Medicine, aortic aneurysm
Published
2019

11. Comparison of Two Different Techniques for Isolated Left Subclavian Artery Revascularization During Thoracic Endovascular Aortic Repair

Author

Piffaretti, Gabriele, primary, Antonello, Michele, additional, Pratesi, Giovanni, additional, Gelpi, Guido, additional, Galli, Mario, additional, Tadiello, Marco, additional, Xodo, Andrea, additional, Barbante, Matteo, additional, Paggi, Anita, additional, Romagnoni, Claudia, additional, Ippoliti, Arnaldo, additional, Grego, Franco, additional, and Castelli, Patrizio, additional

Published
2019
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12. Endovascular Treatment of Isolated Common Iliac Artery Aneurysms Using Iliac Branch Stent-grafts Without Aortic Component: A National Multicenter Registry

Author

Giaquinta, Alessia, primary, Davì, Alberto, additional, Ferrer, Ciro, additional, Orrico, Matteo, additional, Barbante, Matteo, additional, Verzini, Fabio, additional, De Donato, Gianmarco, additional, Fargion, Aaron, additional, Ardita, Vincenzo, additional, and Veroux, Pierfrancesco, additional

Published
2019
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13. Coexisting hypogastric aneurysms worsen the outcomes of endovascular treatment by the iliac branch devices within the pELVIS Registry

Author

Donas, Konstantinos P., primary, Taneva, Gergana T., additional, Pitoulias, Georgios A., additional, Torsello, Giovanni, additional, Veith, Frank J., additional, Austermann, Martin, additional, Inchingolo, Mirjam, additional, Bisdas, Theodosios, additional, Pratesi, Giovanni, additional, Barbante, Matteo, additional, Cao, Piergiorgio, additional, Ferrer, Ciro, additional, Verzini, Fabio, additional, Parlani, Gianbatista, additional, Simonte, Gioele, additional, Pratesi, Carlo, additional, Fargion, Aaron, additional, Masciello, Fabrizio, additional, Kölbel, Tilo, additional, Tsilimparis, Nikolaos, additional, Haulon, Stephan, additional, Branzan, Daniela, additional, Schmidt, Andrej, additional, and Scheinert, Dirk, additional

Published
2019
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14. Results of Iliac Branch Devices in Octogenarians Within the pELVIS Registry.

Author

Fargion, Aaron Thomas, Masciello, Fabrizio, Pratesi, Giovanni, Torsello, Giovanni, Donas, Konstantinos P., Pratesi, Carlo, Austermann, Martin, Inchingolo, Mirjam, Bisdas, Theodosios, Pitoulias, Georgios A., Taneva, Gergana T., Dorigo, Walter, Ippoliti, Arnaldo, Barbante, Matteo, Cao, Piergiorgio, Ferrer, Ciro, Verzini, Fabio, Parlani, Gianbattista, Simonte, Gioele, and Kölbel, Tilo

Abstract

Purpose: To evaluate if the elderly could benefit from the implantation of iliac branch devices (IBDs) to preserve the patency of the internal iliac artery (IIA) in aneurysms involving the iliac bifurcation. Materials and Methods: From January 2005 to April 2017, 804 patients enrolled in the pELVIS registry underwent endovascular aneurysm repair with 910 IBDs due to aneurysmal involvement of the iliac bifurcation. Among the 804 patients, 157 (19.5%) were octogenarians (mean age 82.9±2.5 years; 157 men) with 171 target IIAs for preservation. Outcomes at 30 days included technical success, death, conversion to open surgery, and major complications. Outcomes evaluated in follow-up were patency of the IBD and target vessels, type I and type III endoleaks, aneurysm-related reinterventions, aneurysm-related death, and overall patient survival. Kaplan-Meier analyses were employed to evaluate the late outcome measures; the estimates are presented with the 95% confidence interval (CI). Results: Technical success was 99.4% with no intraoperative conversions or deaths (1 bridging stent could not be implanted, and the IIA was sacrificed). Perioperative mortality was 1.9%. The overall perioperative aneurysm-related complication rate was 8.9% (14/157), with an early reintervention rate of 5.1% (8/157). Median postoperative radiological and clinical follow-up were 21.8 months (range 1–127) and 29.3 months (range 1–127), respectively. Estimated rates of freedom from occlusion of the IBD, the IIA, and the external iliac artery at 60 months were 97.7% (95% CI 96.1% to 99.3%), 97.3% (95% CI 95.7% to 98.9%), and 98.6% (95% CI 97% to 99.9%), respectively. Estimated rates of freedom from type I and type III endoleaks and device migration at 60 months were 90.9% (95% CI 87% to 94.3%), 98.7% (95% CI 97.5% to 99.8%), and 98% (95% CI 96.4% to 99.6%), respectively. Freedom from all cause reintervention at 60 months was 87.4% (95% CI 82.6% to 92.2%). The estimated overall survival rate at 60 months was 59% (95% CI 52.4% to 65.6%). Conclusion: IBD implantation in octogenarians provided acceptable perioperative mortality and morbidity rates, with satisfying long-term freedom from IBD-related complications and should be considered a feasible repair option for selected elderly patients affected by aneurysms involving the iliac bifurcation. [ABSTRACT FROM AUTHOR]

Published
2021
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15. Bilateral Use of Iliac Branch Devices for Aortoiliac Aneurysms Is Safe and Feasible, and Procedural Volume Does Not Seem to Affect Technical or Clinical Effectiveness: Early and Midterm Results From the pELVIS International Multicentric Registry

Author

D’Oria, Mario, Pitoulias, Georgios A., Torsello, Giovanni F., Pitoulias, Apostolos G., Fazzini, Stefano, Masciello, Fabrizio, Verzini, Fabio, Donas, Konstantinos P., Taneva, Gergana T., Austermann, Martin, Bosiers, Michel, Dorigo, Walter, Cao, Piergiorgio, Ferrer, Ciro, Ippoliti, Arnaldo, Barbante, Matteo, Parlani, Gianbattista, Simonte, Gioele, Kölbel, Tilo, Tsilimparis, Nikolaos, Haulon, Stephan, Branzan, Daniela, Schmidt, Andrej, Pratesi, Carlo, Fargion, Aaron, and Pratesi, Giovanni

Abstract

Objective To evaluate early and follow-up outcomes following bilateral use of iliac branch devices (IBD) for aortoiliac endografting and assess the impact of center volume. We used data from the pELVIS international multicentric registry.Methods For the purpose of this study, only those patients receiving concomitant bilateral IBD implantation were analyzed. To assess the impact that procedural volume of bilateral IBD implantation could have on early and follow-up outcomes, participating institutions were classified as Site(s) A if they had performed >10 and/or >20% concomitant bilateral IBD procedure, otherwise they were classified as Site(s) B. Endpoints of the analysis included early (ie, 30-day) mortality and morbidity, as well as all-cause and aneurysm-related mortality during follow-up. Additional endpoints that were evaluated included IBD-related reinterventions, IBD occlusion or stenosis requiring reintervention (ie, loss of primary patency), and IBD-related type I endoleak.Results Overall, 96 patients received bilateral IBD implantation (out of 910 procedures collected in the whole pELVIS cohort), of whom 65 were treated at Site A (ie, Group A) and 31 were treated at Site(s) B (ie, Group B). In total, only 1 death occurred within 30 days from bilateral IBD implantation, and 9 patients experienced at least 1 major complication without any significant difference between subjects in Group A versus those in Group B (10.8% vs 6.5%, p=0.714). In the overall cohort, the 2-year freedom from IBD-related type I endoleaks and IBD primary patency were 96% and 92%, respectively; no significant differences were seen in those rates between Group A or Group B (95% vs 100%, p=0.335; 93% vs 88%, p=0.470). Freedom from any IBD-related reinterventions was 83% at 2 years, with similar rates between study groups (85% vs 83%, p=0.904).Conclusions Within the pELVIS registry, concomitant bilateral IBD implantation is a safe and feasible technique for management of aortoiliac aneurysms in patients with suitable anatomy. Despite increased technical complexity, effectiveness of the repair is satisfactory with low rates of IBD-related adverse events at mid-term follow-up. Procedural volume does not seem to affect technical or clinical outcomes after bilateral use of IBD, which remains a favorable treatment option in selected patients.

Published
2021
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16. Results of the multicenter pELVIS Registry for isolated common iliac aneurysms treated by the iliac branch device

Author

Fargion, Aaron T., primary, Masciello, Fabrizio, additional, Pratesi, Carlo, additional, Pratesi, Giovanni, additional, Torsello, Giovanni, additional, Donas, Konstantinos P., additional, Austermann, Martin, additional, Weiss, Kristin, additional, Bosiers, Michel, additional, Dorigo, Walter, additional, Cao, Piergiorgio, additional, Ferrer, Ciro, additional, Ippoliti, Arnaldo, additional, Barbante, Matteo, additional, Pitoulias, Georgios A., additional, Verzini, Fabio, additional, Parlani, Gianbattista, additional, Simonte, Gioele, additional, Kölbel, Tilo, additional, Tsilimparis, Nikolaos, additional, Haulon, Stephan, additional, Branzan, Daniela, additional, and Schmidt, Andrej, additional

Published
2018
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17. Comparison of Two Different Techniques for Isolated Left Subclavian Artery Revascularization During Thoracic Endovascular Aortic Repair in Zone 2

Author

Piffaretti, Gabriele, primary, Pratesi, Giovanni, additional, Gelpi, Guido, additional, Galli, Mario, additional, Criado, Frank J., additional, Antonello, Michele, additional, Fontana, Federico, additional, Piacentino, Filippo, additional, Macchi, Edoardo, additional, Tozzi, Matteo, additional, Castelli, Patrizio, additional, Barbante, Matteo, additional, Ippoliti, Arnaldo, additional, Romagnoni, Claudia, additional, Antona, Carlo, additional, Paggi, Anita, additional, Xodo, Andrea, additional, and Grego, Franco, additional

Published
2018
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18. Isolated Common Iliac Artery Aneurysms Treated Solely With Iliac Branch Stent-Grafts: Midterm Results of a Multicenter Registry

Author

Giaquinta, Alessia, primary, Ardita, Vincenzo, additional, Ferrer, Ciro, additional, Beggs, Clive B., additional, Veroux, Massimiliano, additional, Barbante, Matteo, additional, Orrico, Matteo, additional, Cao, Piergiorgio, additional, Veroux, Piefrancesco, additional, Mangialardi, Nicola, additional, Ronchey, Sonia, additional, Lenti, Massimo, additional, Verzini, Fabio, additional, Parlani, Gianbattista, additional, Ippoliti, Arnaldo, additional, Pratesi, Giovanni, additional, Coscarella, Carlo, additional, Setacci, Carlo, additional, de Donato, Gianmarco, additional, Galzerano, Giuseppe, additional, Pratesi, Carlo, additional, Fargion, Aaron, additional, Veroux, Chiara, additional, Mociskyte, Dovile, additional, De Marco, Ester, additional, Virgilio, Carla, additional, and Virgilio, Vittorio, additional

Published
2018
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19. Long-term prevention of stroke: a modern comparison of current carotid stenting and carotid endarterectomy

Author

De Rango, Paola, Parlani, Gianbattista, Verzini, Fabio, Giordano, Giuseppe, Panuccio, Giuseppe, Barbante, Matteo, and Cao, Piergiorgio

Subjects
Aged, 80 and over, Male, RISK, Endarterectomy, Carotid, endarterectomy, stroke ARTERY STENOSIS, angioplasty, stenting, Kaplan-Meier Estimate, Middle Aged, THERAPY, RANDOMIZED-TRIAL, Stroke, carotid, Treatment Outcome, REGISTRY, Humans, Carotid Stenosis, Female, Stents, ANGIOPLASTY, Aged, Follow-Up Studies
Abstract

ObjectivesThis study sought to evaluate long-term outcomes of carotid stenting (CAS) versus carotid endarterectomy (CEA) based on physician-guided indications.BackgroundThe issue regarding long-term outcome of CAS versus CEA in patients with carotid stenosis is clinically relevant but remains unsettled.MethodsConsecutive patients (71% men, mean age 71.3 years) treated by CEA (n = 1,118) or CAS (n = 1,084) after a training phase were reviewed. Selection of treatment was based on better-suitability characteristics (morphology and clinical). Data were adjusted with propensity score analysis and stratified by symptoms, age, and sex.ResultsThirty-day stroke/death rates were similar: 2.8% in CAS and 2.0% in CEA (p = 0.27). The risk was higher in symptomatic (3.5%) versus asymptomatic (2.0%) patients (p = 0.04) but without significant difference between CAS and CEA groups. Five-year survival rates were 82.0% in CAS and 87.7% in CEA (p = 0.05). Kaplan-Meier estimates of the composite of any periprocedural stroke/death and ipsilateral stroke at 5 years after the procedure were similar in all patients (4.7% vs. 3.7%; p = 0.4) and the subgroups of symptomatic (8.7% vs. 4.9%; p = 0.7) and asymptomatic (2.5% vs. 3.3%; p = 0.2) patients in CEA versus CAS, respectively. Cox analysis, adjusted by propensity score, identified statin treatment (p = 0.016) and symptomatic disease (p = 0.003) associated with the composite end point. There were no sex- or age-related significant outcome differences.ConclusionsWhen physicians use their clinical judgment to select the appropriate technique for carotid revascularization CAS can offer efficacy and durability comparable to CEA with benefits persisting at 5 years.

Published
2011

21. Secondary Procedures Following Iliac Branch Device Treatment of Aneurysms Involving the Iliac Bifurcation: The pELVIS Registry

Author

Donas, Konstantinos P., Inchingolo, Mirjam, Cao, Piergiorgio, Pratesi, Carlo, Pratesi, Giovanni, Torsello, Giovanni, Pitoulias, Georgios A., Ferrer, Ciro, Parlani, Gianbattista, Verzini, Fabio, Austermann, Martin, Weiss, Kristin, Bosiers, Michel, Barbante, Matteo, Simonte, Gioele, Fargion, Aaron, and Masciello, Fabrizio

Abstract

Purpose:To evaluate the incidence and reasons for secondary procedures in patients treated with iliac branch devices (IBDs) for isolated iliac aneurysm or aortoiliac aneurysms involving the iliac bifurcation. Methods:Between January 2005 and December 2015, 575 surgical-high-risk patients (mean age 72.0±8.4 years; 558 men) with isolated iliac aneurysms (n=79) or aortoiliac aneurysms involving the iliac bifurcation (n=496) were treated with placement of 650 ZBIS or Gore IBDs (75 bilateral) in 6 European centers. The primary outcome was procedure-related reinterventions for occlusion or high-grade (>70%) stenosis of the bridging device, occlusion of the ipsilateral common or external iliac artery (EIA), type I/III endoleak, rupture, or infection following IBD implantation. Clinical and radiological data were analyzed based on preset definitions of comorbidities, aneurysm morphology, intraoperative variables, and follow-up strategies. Results:Nine (1.6%) reinterventions were performed within 30 days for occlusion or endoleak. Among 10 (1.5%) occluded EIAs ipsilateral to a deployed IBD, 6 underwent a reintervention with additional stent placement after thrombolysis (n=4) or a femorofemoral or iliofemoral crossover bypass (n=2). Three of 14 patients with early type I endoleak had a reintervention for an insufficient proximal sealing zone (stent-grafts in 2 common iliac arteries and 1 bifurcated endograft). Mean clinical and radiological follow-up were 32.6±9.9 and 29.8±21.1 months, respectively. Forty-two (7.3%) patients underwent reinterventions in the follow-up period. The overall postoperative reintervention rate was 8.9%. Both external and common iliac segments occluded in 30 (4.6%) IBDs; 2 patients had a crossover bypass and 14 were treated with endovascular techniques. In the other 14 patients, no specific treatment was performed. Seven (1.2%) patients with isolated EIA occlusion were treated during follow-up. Nineteen of the overall 28 patients with type I endoleak underwent endovascular repair. The other 9 were under radiological surveillance due to less significant (<5 mm) sac increase. No reintervention was performed to recanalize 11 (1.6%) occluded internal iliac arteries. Conclusion:Midterm experience with placement of IBDs is associated with a low incidence of secondary procedures due to type I endoleaks and occlusions. The main reasons for reinterventions seem to be short proximal sealing zone and poor conformability of the ZBIS device in elongated EIAs.

Published
2017
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22. Long-Term Prevention of Stroke

Author

De Rango, Paola, primary, Parlani, Gianbattista, additional, Verzini, Fabio, additional, Giordano, Giuseppe, additional, Panuccio, Giuseppe, additional, Barbante, Matteo, additional, and Cao, Piergiorgio, additional

Published
2011
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