Affordable Access

Access to the full text

Onyx Embolization for Occlusion of the Proximal Internal Iliac Artery During EVAR in Patients with Unsuitable Landing Zones in the Common Iliac Artery

Authors
  • Kjellin, Per1, 2
  • Pärsson, Håkan1, 3
  • Lindgren, Hans I. V.1, 2
  • 1 Helsingborg Hospital, Department of Surgery, Helsingborg, 251 87, Sweden , Helsingborg (Sweden)
  • 2 Lund University, Department of Clinical Sciences, Faculty of Medicine, Lund, Sweden , Lund (Sweden)
  • 3 Linköping University, Department of Clinical and Experimental Medicine, Linköping, Sweden , Linköping (Sweden)
Type
Published Article
Journal
CardioVascular and Interventional Radiology
Publisher
Springer-Verlag
Publication Date
Mar 07, 2019
Volume
42
Issue
7
Pages
956–961
Identifiers
DOI: 10.1007/s00270-019-02188-8
Source
Springer Nature
Keywords
License
Yellow

Abstract

BackgroundTwenty percent of the patients with AAA have an aneurysm involving the common iliac arteries. Large common iliac diameter can be treated with an iliac branched device or extension of the stent graft to the external iliac artery with occlusion of the ipsilateral internal iliac artery (IIA) to prevent type 2 endoleaks. This study describes and evaluates a embolization technique using Onyx in conjunction with EVAR in aneurysms with poor landing zones in the common iliac arteries.MethodsPatients with Onyx IIA embolization during EVAR, identified from the hospital operating code database, constitute the study population. Onyx embolization was performed by injection at the IIA origin. Peri- and postoperative complications were collected from the medical records. Thin-sliced CT scan was performed 1 month and 1 year after the procedure.ResultsThirty-six patients with complex iliac anatomy and insufficient landing zones (without sealing possibility for standard stent grafts) were identified out of 243 consecutive EVAR treatments during a 13-year period. In seventeen patients (7%), the IIA was embolized with Onyx. Technical success was obtained in all 17 patients, without adverse event or procedural complication. No complication related to the embolization procedure was noted during follow-up.ConclusionsDuring EVAR treatment of patients with aneurysm involving the common iliac artery, Onyx embolization of IIA is a feasible option without need of selective catheterization of the IIA orifice, potentially preserving important branches of the IIA and simplifying emergency procedures.

Report this publication

Statistics

Seen <100 times