Endovascular treatment experiences on complex aorto-iliac aneurysms

Aim: Nowadays, endovascular approach in abdominal aortic aneurysms has almost replaced open surgery. The strategy is common and relatively easy when it can be terminated in both common iliac arteries. Conversely, in cases where it has to be extended to the external iliac artery, the decision for additional intervention in the internal iliac artery is controversial. This study aimed to share our experiences on endovascular approaches to aorto-iliac aneurysms. Material and Methods: This study included 28 patients who underwent EVAR, which was extended to the EIA. Anatomical shape of IIA, interventional success, presence of leakage, presence of complication related to IIA occlusion, and any time results were recorded and evaluated. Results: The mean age was 68 + 9,3 (42-81) years with a higher male population (n: 24, 85,7%). Follow-up durations varied between 2 days and 26 months. In four patients, interventions were performed under emergency conditions. Iliac branched grafts were used for six patients. In three patients, IIA was occluded with occlusion devices. There was no transition to open surgical repair. Buttock claudication was seen in 8 patients (28,5%), and there was no new onset erectile dysfunction after occlusion of IIAs. Discussion: AIAs may be treated with favorable results through endovascular approaches. Since decision-making will depend on the available devices in the clinic, treatment options can occasionally be changed. Therefore, learning different approaches might be helpful for practitioners.