Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Internal Iliac Artery Embolization during an Endovascular Aneurysm Repair with Detachable Interlock Microcoils

  • Kim, Woo Chul (Department of Radiology, Inha University Hospital, Inha University School of Medicine) ;
  • Jeon, Yong Sun (Department of Radiology, Inha University Hospital, Inha University School of Medicine) ;
  • Hong, Kee Chun (Department of Vascular Surgery, Inha University Hospital, Inha University School of Medicine) ;
  • Kim, Jang Yong (Department of Vascular and Endovascular Surgery, The Catholic University of Korea School of Medicine) ;
  • Cho, Soon Gu (Department of Radiology, Inha University Hospital, Inha University School of Medicine) ;
  • Park, Jae Young (Department of Vascular Surgery, Inha University Hospital, Inha University School of Medicine)
  • Received : 2013.07.28
  • Accepted : 2014.06.09
  • Published : 2014.09.01
⟨ Previous Next ⟩

Abstract

Objective: The purpose of this study was to evaluate the effectiveness of detachable interlock microcoils for an embolization of the internal iliac artery during an endovascular aneurysm repair (EVAR). Materials and Methods: A retrospective review was conducted on 40 patients with aortic aneurysms, who had undergone an EVAR between January 2010 and March 2012. Among them, 16 patients were referred for embolization of the internal iliac artery for the prevention of type II endoleaks. Among 16 patients, 13 patients underwent embolization using detachable interlock microcoils during an EVAR. Computed tomographic angiographies and clinical examinations were performed during the follow-up period. Technical success, clinical outcome, and complications were reviewed. Results: Internal iliac artery embolizations using detachable interlock microcoils were technically successful in all 13 patients, with no occurrence of procedure-related complications. Follow-up imaging was accomplished in the 13 cases. In all cases, type II endoleak was not observed with computed tomographic angiography during the median follow-up of 3 months (range, 1-27 months) and the median clinical follow-up of 12 months (range, 1-27 months). Two of 13 (15%) patients had symptoms of buttock pain, and one patient died due to underlying stomach cancer. No significant clinical symptoms such as bowel ischemia were observed. Conclusion: Internal iliac artery embolization during an EVAR using detachable interlock microcoils to prevent type II endoleaks appears safe and effective, although this should be further proven in a larger population.

Keywords

Acknowledgement

Supported by : Inha University

References

  1. Schoder M, Zaunbauer L, Holzenbein T, Fleischmann D, Cejna M, Kretschmer G, et al. Internal iliac artery embolization before endovascular repair of abdominal aortic aneurysms: frequency, efficacy, and clinical results. AJR Am J Roentgenol 2001;177:599-605 https://doi.org/10.2214/ajr.177.3.1770599
  2. Ha CD, Calcagno D. Amplatzer Vascular Plug to occlude the internal iliac arteries in patients undergoing aortoiliac aneurysm repair. J Vasc Surg 2005;42:1058-1062 https://doi.org/10.1016/j.jvs.2005.08.017
  3. Murphy KD, Richter GM, Henry M, Encarnacion CE, Le VA, Palmaz JC. Aortoiliac aneurysms: management with endovascular stent-graft placement. Radiology 1996;198:473-480 https://doi.org/10.1148/radiology.198.2.8596852
  4. Lee C, Dougherty M, Calligaro K. Concomitant unilateral internal iliac artery embolization and endovascular infrarenal aortic aneurysm repair. J Vasc Surg 2006;43:903-907 https://doi.org/10.1016/j.jvs.2005.12.063
  5. Cynamon J, Lerer D, Veith FJ, Taragin BH, Wahl SI, Lautin JL, et al. Hypogastric artery coil embolization prior to endoluminal repair of aneurysms and fistulas: buttock claudication, a recognized but possibly preventable complication. J Vasc Interv Radiol 2000;11:573-577 https://doi.org/10.1016/S1051-0443(07)61608-X
  6. Marin ML, Veith FJ, Lyon RT, Cynamon J, Sanchez LA. Transfemoral endovascular repair of iliac artery aneurysms. Am J Surg 1995;170:179-182 https://doi.org/10.1016/S0002-9610(99)80281-5
  7. Razavi MK, DeGroot M, Olcott C 3rd, Sze D, Kee S, Semba CP, et al. Internal iliac artery embolization in the stent-graft treatment of aortoiliac aneurysms: analysis of outcomes and complications. J Vasc Interv Radiol 2000;11:561-566 https://doi.org/10.1016/S1051-0443(07)61606-6
  8. Kickuth R, Dick F, Triller J, Ludwig K, Schmidli J, Do DD. Internal iliac artery embolization before endovascular repair of aortoiliac aneurysms with a nitinol vascular occlusion plug. J Vasc Interv Radiol 2007;18:1081-1087 https://doi.org/10.1016/j.jvir.2007.06.013
  9. Harris PL, Buth J, Mialhe C, Myhre HO, Norgren L. The need for clinical trials of endovascular abdominal aortic aneurysm stent-graft repair: The EUROSTAR Project. EUROpean collaborators on Stent-graft Techniques for abdominal aortic Aneurysm Repair. J Endovasc Surg 1997;4:72-77; discussion 78-79 https://doi.org/10.1583/1074-6218(1997)004<0072:TNFCTO>2.0.CO;2
  10. Cekirge HS, Saatci I, Firat MM, Balkanci F, Besim A. Interlocking detachable coil occlusion in the endovascular treatment of intracranial aneurysms: preliminary results. AJNR Am J Neuroradiol 1996;17:1651-1657
  11. Reidy JF, Qureshi SA. Interlocking detachable platinum coils, a controlled embolization device: early clinical experience. Cardiovasc Intervent Radiol 1996;19:85-90 https://doi.org/10.1007/BF02563899
  12. Sacks D, McClenny TE, Cardella JF, Lewis CA. Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 2003;14(9 Pt 2):S199-S202 https://doi.org/10.1097/01.RVI.0000094584.83406.3e
  13. Armon MP, Yusuf SW, Latief K, Whitaker SC, Gregson RH, Wenham PW, et al. Anatomical suitability of abdominal aortic aneurysms for endovascular repair. Br J Surg 1997;84:178-180 https://doi.org/10.1002/bjs.1800840210
  14. Brewster DC, Geller SC, Kaufman JA, Cambria RP, Gertler JP, LaMuraglia GM, et al. Initial experience with endovascular aneurysm repair: comparison of early results with outcome of conventional open repair. J Vasc Surg 1998;27:992-1003; discussion 1004-1005 https://doi.org/10.1016/S0741-5214(98)70002-3
  15. Young AT, Tadavarthy SM, Yedlicka Jr JW, Hunter DW, Becker GJ, Herrera MA, et al. Vasculary embolotherapy. In: Castaneda-Zuniga WR, Tadavarthy SM, eds. Interventional radiology, 2nd ed. Baltimore: Williams & Wilkins, 1992:9-200
  16. Vandy F, Criado E, Upchurch GR Jr, Williams DM, Rectenwald J, Eliason J. Transluminal hypogastric artery occlusion with an Amplatzer vascular plug during endovascular aortic aneurysm repair. J Vasc Surg 2008;48:1121-1124 https://doi.org/10.1016/j.jvs.2008.06.002
  17. Park KM, Yang SS, Kim YW, Park KB, Park HS, Do YS, et al. Clinical outcomes after internal iliac artery embolization prior to endovascular aortic aneurysm repair. Surg Today 2014;44:472 -477 https://doi.org/10.1007/s00595-013-0572-y
  18. Nancarrow PA, Fellows KE, Lock JE. Stability of coil emboli: an in vitro study. Cardiovasc Intervent Radiol 1987;10:226-229 https://doi.org/10.1007/BF02593876
  19. Kruger K, Wagner D, Gawenda M, Strohe D, Uedelhoven J, Brunkwall J, et al. [Coil embolization of arteriovenous fistulae on in situ saphenous vein bypasses: success rate and complications]. Rofo 2007;179:587-592 https://doi.org/10.1055/s-2007-962922
  20. Goh RH, Sniderman KW, Kalman PG. Long-term follow-up of management of failing in situ saphenous vein bypass grafts using endovascular intervention techniques. J Vasc Interv Radiol 2000;11:705-712 https://doi.org/10.1016/S1051-0443(07)61628-5
  21. Farahmand P, Becquemin JP, Desgranges P, Allaire E, Marzelle J, Roudot-Thoraval F. Is hypogastric artery embolization during endovascular aortoiliac aneurysm repair (EVAR) innocuous and useful? Eur J Vasc Endovasc Surg 2008;35:429-435 https://doi.org/10.1016/j.ejvs.2007.12.001
  22. Mehta M, Veith FJ, Ohki T, Cynamon J, Goldstein K, Suggs WD, et al. Unilateral and bilateral hypogastric artery interruption during aortoiliac aneurysm repair in 154 patients: a relatively innocuous procedure. J Vasc Surg 2001;33(2 Suppl):S27-S32 https://doi.org/10.1067/mva.2001.111678
  23. Marks MP, Chee H, Liddell RP, Steinberg GK, Panahian N, Lane B. A mechanically detachable coil for the treatment of aneurysms and occlusion of blood vessels. AJNR Am J Neuroradiol 1994;15:821-827
  24. Dudeck O, Bulla K, Wieners G, Ruehl R, Ulrich G, Amthauer H, et al. Embolization of the gastroduodenal artery before selective internal radiotherapy: a prospectively randomized trial comparing standard pushable coils with fibered interlock detachable coils. Cardiovasc Intervent Radiol 2011;34:74-80
  25. Seo JM, Park KB, Kim KH, Jeon P, Shin SW, Park HS, et al. Clinical and multidetector CT follow-up results of renal artery aneurysms treated by detachable coil embolization using 3D rotational angiography. Acta Radiol 2011;52:854-859 https://doi.org/10.1258/ar.2011.110063
  26. Pellerin O, Caruba T, Kandounakis Y, Novelli L, Pineau J, Prognon P, et al. Embolization of the internal iliac artery: cost-effectiveness of two different techniques. Cardiovasc Intervent Radiol 2008;31:1088-1093 https://doi.org/10.1007/s00270-008-9374-9
  27. Ferro C, Rossi UG, Bovio G, Petrocelli F, Seitun S. The Amplatzer vascular plug 4: preliminary experience. Cardiovasc Intervent Radiol 2010;33:844-848 https://doi.org/10.1007/s00270-009-9749-6
  28. Libicher M, Pavlidis D, Bangard C, Gawenda M. Occlusion of the internal iliac artery prior EVAR: comparison of coils and plugs. Vasc Endovascular Surg 2012;46:34-39 https://doi.org/10.1177/1538574411427786
  29. Yano OJ, Morrissey N, Eisen L, Faries PL, Soundararajan K, Wan S, et al. Intentional internal iliac artery occlusion to facilitate endovascular repair of aortoiliac aneurysms. J Vasc Surg 2001;34:204-211 https://doi.org/10.1067/mva.2001.115380
  30. Mehta M, Veith FJ, Ohki T. When should the internal iliac arteries be preserved in patients undergoing endovascular or open repair of aortoiliac aneurysms? Vasc Surg Endovasc Ther 2001;14:17-28
  31. Karch LA, Hodgson KJ, Mattos MA, Bohannon WT, Ramsey DE, McLafferty RB. Adverse consequences of internal iliac artery occlusion during endovascular repair of abdominal aortic aneurysms. J Vasc Surg 2000;32:676-683 https://doi.org/10.1067/mva.2000.109750