We report our experience of endovascular repair of isolated iliac artery
aneurysms using commercially available
stent grafts (SGs). Twenty-five patients (mean age 71 +/- 7 years) presented with 33 isolated iliac artery
aneurysms (common iliac artery n = 29, external iliac artery n = 4). Five patients were symptomatic. Depending on the proximal iliac neck and the presence of unilateral or bilateral iliac artery
aneurysms, the patient was treated by tube or bifurcated SG that was delivered percutaneously (n = 14) or through surgical exposure of one femoral artery (n = 12). In our follow-up control protocol, the patients are routinely scheduled after 1, 4, and 12 months and then annually after the intervention. Primary technical success with an instant exclusion of the
aneurysm was achieved in all patients. The perioperative (<30 days) mortality rate was 0. Major complications did not occur. Mean hospitalization was 6 +/- 6 days (range 2-28, median 4). Four patients (16%) died during follow-up. At a mean follow-up of 32 months (range 3-72, median 36), we detected three type 1
endoleaks (14.3%) that were managed with additional SG; two
stenoses at the distal extremity of the SGs, treated with mechanical
thrombectomy; and additional
stent. In the remaining patients (n = 17), computed tomography angiography confirmed the patency of the SG and the absence of device complication (e.g.,
endoleak, migration, breakage); shrinkage of the
aneurysm was observed in 11 cases (52.4%). Overall, survival rates at 1, 4, and 5 years were 91.6%, 73.3%, and 58.6%, respectively; event-free rates at 1 and 3 years were 79.4% and 67.4%, respectively. In our experience, SG treatment for isolated iliac artery
aneurysm proved to be a feasible and low-risk procedure with acceptable mid-term results. At our institute, it is the primary alternative to conventional surgical repair and is offered as first-line treatment.