[Complications of Hypogastric Arteries Embolization in EVAR].

Objective: The aim of this paper is dedicated to assess the risks of the embolization of the hypogastric arteries following the endovascular management of aorto-iliac aneurysms, looking at the incidence and nature of the most common complications, in the unilateral "versus" bilateral embolization with coils.
Methods: A systematic review of the literature was made on the subject, including the outcome of patients who underwent unilateral versus bilateral embolization of hypogastric arteries with coils in the EVAR.
Results: The most common complications were buttock claudication and erectile disfunction, with an estimation respectively of 28% and 15%, independently of the unilateral or bilateral procedure. Less commonly, colonic ischemia was found in 2%, as well as spinal cord ischemia, also found in 2%.
Conclusions: The embolization of the hypoastric arteries may extend the field of utilization of the EVAR, however it cannot be regarded as an innocuous procedure. This systematic review suggests that more complications can be expected in patients who underwent bilateral versus unilateral embolization, namely related to buttock claudication. However, a similar evidence could not be demonstrated with erectile disfunction.