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International Journal of Vascular Medicine
Volume 2014 (2014), Article ID 178610, 14 pages
http://dx.doi.org/10.1155/2014/178610
Clinical Study

Complex Common and Internal Iliac or Aortoiliac Aneurysms and Current Approach: Individualised Open-Endovascular or Combined Procedures

1Vascular Unit, 2nd Clinic of Surgery, School of Medicine, University of Athens, Aretaieion Hospital, Vas. Sophias 76, 115 28 Athens, Greece
21st Department of Anesthesiology, School of Medicine, University of Athens, Aretaieion Hospital, Vas. Sophias 76, 115 28 Athens, Greece

Received 14 February 2014; Revised 12 July 2014; Accepted 14 July 2014; Published 28 September 2014

Academic Editor: Mark Morasch

Copyright © 2014 Thomas Kotsis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Bilateral internal iliac artery aneurysms constitute the utmost configuration of infrarenal aortoiliac disease. We detail characteristic aortoiliac disease patterns and reconstructive techniques we have used, along with a visualized decision-making chart and a short review of the literature. Material and Methods. A retrospective, observational study of twelve clinical cases of patients with aortoiliac disease are described. Two patients had a common iliac artery aneurysm and were managed by the application of inversed stent-grafts; another case was repaired by the insertion of a standard bifurcated stent-graft flared in the right common iliac artery and with an iliac branched device in the left iliac arterial axis. Open approach was used in 5 cases and in 4 cases a combination of aortouniliac stent-grafting with femoral-femoral bypass was applied. Results. Technical success was 100%. One endoleak type Ib in a flared iliac limb was observed and corrected by internal iliac embolism and use of an iliac limb stent-graft extension. We report 100% patency rate during 26.3 months of followup. Conclusion. Individualized techniques for the management of isolated iliac or aortoiliac aneurismal desease with special concern in maintaining internal iliac artery perfusion lead to elimination of perioperative complications and long-term durability and patency rates.