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• W2804290067 abstract "The endovascular treatment of abdominal aortic aneurysm may require the use of flared iliac limbs (FLs) to deal with dilated common iliac arteries in a significant number of cases; however, scarce data are reported in the literature on their long-term efficacy. The aim of this study was to evaluate possible predictors of FL outcome in endovascular aneurysm repair (EVAR). From 2012 to 2016, all data of patients submitted to EVAR were prospectively collected into a dedicated database to evaluate iliac complications (ICs), defined as type IB endoleak, type IIIA endoleak, and limb occlusion. The outcome of nondilated (diameter <16 mm) common iliac arteries treated with standard iliac limb (SL) was compared with that of dilated (diameter >16 mm) common iliac arteries treated with FL. Follow-up was performed by duplex ultrasound scan evaluation at 3, 6, and 12 months and yearly thereafter; computed tomography angiography was performed in case of ICs. Specific anatomic and technical risk factors for ICs were investigated by Cox regression analysis and life-table analysis. In the designated period, 533 patients were included in the analysis, for a total of 1066 limbs: 808 (76%) SL and 258 (24%) FL. Overall, no ICs (0%) occurred at 30 days. At a mean follow-up of 38 ± 8 months, 10 (1%) ICs occurred (4 limb occlusions, 6 type IB endoleaks): 7 (3%) in FL and 3 (0.4%) in SL (P = .20). By life-table analysis, there were no differences in limb occlusions and type IB endoleak-free survival at 5 years in patients with SL vs FL (99% ± 1% vs 98% ± 1% [P = .30]; 96% ± 3% vs 97% ± 1% [P = .44], respectively); similarly, the overall IC rate at 5 years was similar in SL vs FL (96% ± 3% vs 95% ± 2%; P = .20). A common iliac length <30 mm and a diameter >20 mm were independent predictors of ICs in FLs at 5 years by Cox regression (hazard ratio, 4.7 [95% confidence interval, 1.02-21.6; P = .04]; hazard ratio, 7.8 [95% confidence interval, 1.05-64.8; P = .03]). Similarly, FL had significantly lower IC-free survival compared with SL when the common iliac length was <30 mm (79% ± 9% vs 98% ± 1%; P = .001) and the diameter was >20 mm (85% ± 7% vs 99% ± 1%; P = .05) by life-table analysis. When both risk factors were present, IC-free survival was significantly lower compared with cases with only one of them (66% ±15% vs 96% ± 2% vs 98% ± 1%; P = .0001). ICs are infrequent after EVAR treatment, both with SL and FL. However, when an FL is employed in a common iliac artery <30 mm in length and >20 mm in diameter, this significantly increases the risk of late complications. This risk is further increased if both characteristics are present." @default.
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• W2804290067 date "2018-06-01" @default.
• W2804290067 modified "2023-09-27" @default.
• W2804290067 title "VESS02. Anatomic Predictors of Complications in Flared Iliac Limbs in Endovascular Aneurysm Repair" @default.
• W2804290067 doi "https://doi.org/10.1016/j.jvs.2018.03.014" @default.
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