Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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The Use of an Iliac Branch Device: Single-Center Study of Endovascular Preservation of Internal Iliac Artery Flow

장골 분지 장치 사용: 내장골동맥 흐름의 혈관내 보존에 대한 단일 기관의 경험

  • Hyeseung Lee (Department of Radiology, Inha University Hospital) ;
  • Jeong-min Lee (Department of Radiology, Inha University Hospital) ;
  • Soongu Cho (Department of Radiology, Inha University Hospital) ;
  • JungUi Hong (Department of Radiology, Inha University Hospital)
  • 이혜승 (인하대학교병원 영상의학과) ;
  • 이정민 (인하대학교병원 영상의학과) ;
  • 조순구 (인하대학교병원 영상의학과) ;
  • 홍정의 (인하대학교병원 영상의학과)
  • Received : 2023.04.12
  • Accepted : 2023.06.30
  • Published : 2023.11.01
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Abstract

Purpose To determine the efficacy and safety of iliac branch device (IBD) implantation and to evaluate its limitations based on 7 years of experience in a single center. Materials and Methods This single-center study included patients with bilateral common iliac artery aneurysms (CIAAs). We investigated follow-up CT and reviewed the internal iliac artery (IIA) patency and complications related to IBD. A retrospective analysis was performed and the overall survival rate and freedom from reintervention rate were reported according to the Kaplan-Meier method. Results Of the 38 patients with CIAAs, only 10 (12 CIAAs) were suitable for IBD treatment. Five patients underwent unilateral IBD insertion with contralateral IIA embolization, and three (60%) showed claudication; however, symptoms resolved within 6 months. The 7-year freedom from IBD-related reintervention rate was 77.8%. No procedure-related deaths occurred. Conclusion IBD has good technical success and long-term patency rates; however, anatomical factors frequently limit its application, particularly in Asians. Additionally, unilateral IIA embolization showed relatively mild complications and a good prognosis; therefore, it can be performed safely for anatomically complex aortoiliac aneurysms.

목적 단일 기관에서 7년간의 장골 분지 장치 사용 경험을 바탕으로 그 효과와 안전성을 확인하고 효용성 및 한계를 고찰하고자 하였다. 대상과 방법 이 연구는 단일 기관에서 총장골동맥류에 장골 분지 장치 삽입술을 받은 환자들을 대상으로 시행했다. 추적 컴퓨터단층촬영 스캔을 분석하고, 내장골동맥의 개방성 및 장골분지 장치 사용과 관련된 합병증을 검토했다. 후향적 분석을 시행하였으며 전체 생존율과 재시술이 필요 없는 환자의 비율을 Kaplan-Meier method에 따라 분석했다. 결과 38명의 총장골동맥류가 있는 환자들 중에서 10명의 환자(12개의 총장골동맥류)만이 해부학적으로 장골 분지 장치 사용에 적합했다. 5명의 환자는 반대측 내장골동맥 색전술과 함께 장골 분지 장치 삽입술을 받았으며, 이 중 3명의 환자(60%)는 합병증으로 파행을 보였으나 모두 6개월 만에 증상이 호전되었다. 또한 7년 후 장골 분지 장치 사용 관련 재시술이 필요없는 환자의 비율은 77.8%였으며 시술과 관련된 사망은 없었다. 결론 장골 분지 장치는 높은 기술적 성공률과 장기 개통률을 보이지만, 아시아인의 경우 해부학적 요인으로 인해 적용이 제한되는 경우가 많다. 또한 단측 내장골동맥 색전술을 시행한 경우에도 경미한 합병증과 좋은 예후를 보였으므로, 해부학적으로 복잡한 총장골동맥류에서 단측 장골 분지 장치 삽입술 및 반대측 내장골동맥 색전술을 선택하여 시행할 수 있다.

Keywords

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