Initial results of the management of aortoiliac aneurysms with GORE® Excluder® Iliac Branched Endoprosthesis
Schönhofer, S.; Mansour, R.; Ghotbi, R.
Journal of Cardiovascular Surgery 56(6): 883-888
2015
ISSN/ISBN: 1827-191X PMID: 26509393 Document Number: 682241
We prospectively observed the outcomes of all patients (N.=15) with an aortoiliac and a common iliac artery aneurysm who were electively treated with the GORE® Excluder® Iliac Branched Endoprosthesis (IBE) with regard to clinical, anatomical and radiological results. We evaluated operative mortality, aneurysm rupture rate and aneurysm related mortality as well as conversion to open surgery, incidence of endoleak, rate of aneurysm migration, aneurysm enlargement, graft patency, reintervention rate and the clinical outcome. Postoperative follow-up included a computed tomography angiography (CTA) before discharge, clinical evaluation and Duplex ultrasound or CTA 3 weeks after the intervention and Duplex ultrasound every 3 months afterwards. Mean patient age was 79 years (range 61-83 years); f/m: 1/2; mean follow-up was 9 months; 80% of the patients presented 2 or more major comorbidities and 1/3 were considered to be not eligible for open repair. Mean hospitalization time was 5 days. Technical success rate was 93.3% (intent-to-treat basis). Mortality within 30 days was 0%; there were no ruptures; type II endoleak directly after the procedure occurred in 20%, dropping to 13.3% after 3 months. We defined the initial technical success in absence of type I endoleaks. The initial technical success rate was 100%. No IBE occlusion or type Ia, Ib or III endoleak was observed during the postoperative follow-up (mean follow-up: 9 months). All of the internal iliac side branches remained patent. Reintervention rate, buttock claudication rate and pelvic complication rate were 0%. The GORE® IBE provides a new and safe alternative for the management of complete endovascular repair of an extensive aortoiliac or common iliac aneurysm while maintaining pelvic blood flow in iliac branched devices. Due to the lower complexity if compared to previous endovascular or hybrid methods, it should be performed in every anatomically suitable case.