Application of a Novel Common-Iliac-Artery Skirt Technology (CST) in Treating Challenge Aorto-Iliac or Isolated Iliac Artery Aneurysms
Purpose: To report a novel common-iliac-artery skirt technology (CST) in treating challenge iliac artery aneurysms.Methods: When required healthy landing zone of common iliac artery (CIA) is not available, CST is a strategy to exclude the internal iliac artery (IIA) and prevent IIA reflux without ne...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.745250/full |
| _version_ | 1819032077700431872 |
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| author | Lunchang Wang Lunchang Wang Chang Shu Chang Shu Chang Shu Quanming Li Quanming Li Ming Li Ming Li Hao He Hao He Xin Li Xin Li Yin Shi Jian Qiu Jian Qiu Tun Wang Tun Wang Chenzi Yang Chenzi Yang Mo Wang Mo Wang Jiehua Li Jiehua Li Hui Wang Hui Wang Likun Sun Likun Sun |
| author_facet | Lunchang Wang Lunchang Wang Chang Shu Chang Shu Chang Shu Quanming Li Quanming Li Ming Li Ming Li Hao He Hao He Xin Li Xin Li Yin Shi Jian Qiu Jian Qiu Tun Wang Tun Wang Chenzi Yang Chenzi Yang Mo Wang Mo Wang Jiehua Li Jiehua Li Hui Wang Hui Wang Likun Sun Likun Sun |
| author_sort | Lunchang Wang |
| collection | DOAJ |
| description | Purpose: To report a novel common-iliac-artery skirt technology (CST) in treating challenge iliac artery aneurysms.Methods: When required healthy landing zone of common iliac artery (CIA) is not available, CST is a strategy to exclude the internal iliac artery (IIA) and prevent IIA reflux without need of embolization. Patients who received endovascular aneurysm repair (EVAR) in our center from 2014 to 2020 were retrospectively screened, and patients treated with CST or with IIA embolization (IIAE) were enrolled.Results: After retrospective screen of 524 EVAR patients, 39 CST patients, 26 IIAE patients, and 7 CST + IIAE patients were enrolled in this study. CST group suggested to have more aged, hyperlipemia, and smoking patients than IIAE group. Two groups had comparable maximal diameter of abdominal aorta (AA), CIA, EIA, but larger diameter of IIA (CST 19.82 ± 2.281 vs. IIAE 27.82 ± 3.401, p = 0.048), and CIA bifurcation (CST 25.01 ± 1.316 vs. IIAE 29.76 ± 2.775, p = 0.087) was found in IIAE group. Anatomy of 79.5% of CST patients and 92.3% of IIAE patients (p = 0.293) was not suitable for potential use of iliac branch device. CST group had significant shorter surgery time (CST 97.42 ± 3.891 vs. IIAE 141.0 ± 8.010, p < 0.001), shorter hospital stay (CST 15.35 ± 0.873 vs. IIAE 19.32 ± 1.067, p = 0.009), lower in-hospital [CST 0% (0/39) vs. IIAE 11.5% (3/26), p = 0.059] and 1-year follow-up stent related MAEs [CST 6.7% (2/30) vs. IIAE 28.6% (6/21), p = 0.052], but comparable mortality and stent related MAEs for all-cohort follow-up analysis comparing to IIAE group. In our study, a lower in-hospital buttock claudication (BC) rate for CST (CST 20.5% vs. IIAE 46.2%, p = 0.053) and a comparable erectile dysfunction (ED) rate (CST 10.3% vs. IIAE 23.1%, p = 0.352) were found between CST and IIAE groups. After 1 year, both groups had about one third relief of BC symptoms [CST 33.3% (4/12) vs. IIAE 30.7% (4/13), p = 1.000]. Subgroup analysis of 14 patents concomitant with IIA aneurysm in CST group and the 7 CST + IIAE patients were carried out, and no difference was found in mortality, stent MAEs, sac dilation, or reintervention rate. Last, illustration of seven typical CST cases was presented.Conclusion: In selected cases, the CST is a safe, feasible-and-effective choose in treating challenge iliac artery aneurysms and preventing IIA endoleak. |
| first_indexed | 2024-12-21T06:56:13Z |
| format | Article |
| id | doaj.art-b55ce89912e14003bbd77aac4a48255c |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-21T06:56:13Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-b55ce89912e14003bbd77aac4a48255c2022-12-21T19:12:20ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-10-01810.3389/fcvm.2021.745250745250Application of a Novel Common-Iliac-Artery Skirt Technology (CST) in Treating Challenge Aorto-Iliac or Isolated Iliac Artery AneurysmsLunchang Wang0Lunchang Wang1Chang Shu2Chang Shu3Chang Shu4Quanming Li5Quanming Li6Ming Li7Ming Li8Hao He9Hao He10Xin Li11Xin Li12Yin Shi13Jian Qiu14Jian Qiu15Tun Wang16Tun Wang17Chenzi Yang18Chenzi Yang19Mo Wang20Mo Wang21Jiehua Li22Jiehua Li23Hui Wang24Hui Wang25Likun Sun26Likun Sun27Department of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaDepartment of Vascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaDepartment of Vascular Surgery, Fuwai Yunnan Cardiovascular Hospital, Kunming, ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaDepartment of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, ChinaVascular Disease Institute of Central South University, Changsha, ChinaPurpose: To report a novel common-iliac-artery skirt technology (CST) in treating challenge iliac artery aneurysms.Methods: When required healthy landing zone of common iliac artery (CIA) is not available, CST is a strategy to exclude the internal iliac artery (IIA) and prevent IIA reflux without need of embolization. Patients who received endovascular aneurysm repair (EVAR) in our center from 2014 to 2020 were retrospectively screened, and patients treated with CST or with IIA embolization (IIAE) were enrolled.Results: After retrospective screen of 524 EVAR patients, 39 CST patients, 26 IIAE patients, and 7 CST + IIAE patients were enrolled in this study. CST group suggested to have more aged, hyperlipemia, and smoking patients than IIAE group. Two groups had comparable maximal diameter of abdominal aorta (AA), CIA, EIA, but larger diameter of IIA (CST 19.82 ± 2.281 vs. IIAE 27.82 ± 3.401, p = 0.048), and CIA bifurcation (CST 25.01 ± 1.316 vs. IIAE 29.76 ± 2.775, p = 0.087) was found in IIAE group. Anatomy of 79.5% of CST patients and 92.3% of IIAE patients (p = 0.293) was not suitable for potential use of iliac branch device. CST group had significant shorter surgery time (CST 97.42 ± 3.891 vs. IIAE 141.0 ± 8.010, p < 0.001), shorter hospital stay (CST 15.35 ± 0.873 vs. IIAE 19.32 ± 1.067, p = 0.009), lower in-hospital [CST 0% (0/39) vs. IIAE 11.5% (3/26), p = 0.059] and 1-year follow-up stent related MAEs [CST 6.7% (2/30) vs. IIAE 28.6% (6/21), p = 0.052], but comparable mortality and stent related MAEs for all-cohort follow-up analysis comparing to IIAE group. In our study, a lower in-hospital buttock claudication (BC) rate for CST (CST 20.5% vs. IIAE 46.2%, p = 0.053) and a comparable erectile dysfunction (ED) rate (CST 10.3% vs. IIAE 23.1%, p = 0.352) were found between CST and IIAE groups. After 1 year, both groups had about one third relief of BC symptoms [CST 33.3% (4/12) vs. IIAE 30.7% (4/13), p = 1.000]. Subgroup analysis of 14 patents concomitant with IIA aneurysm in CST group and the 7 CST + IIAE patients were carried out, and no difference was found in mortality, stent MAEs, sac dilation, or reintervention rate. Last, illustration of seven typical CST cases was presented.Conclusion: In selected cases, the CST is a safe, feasible-and-effective choose in treating challenge iliac artery aneurysms and preventing IIA endoleak.https://www.frontiersin.org/articles/10.3389/fcvm.2021.745250/fullaorto-iliac artery aneurysmiliac artery aneurysminternal iliac arterynovel technologyendovascularaortic surgery |
| spellingShingle | Lunchang Wang Lunchang Wang Chang Shu Chang Shu Chang Shu Quanming Li Quanming Li Ming Li Ming Li Hao He Hao He Xin Li Xin Li Yin Shi Jian Qiu Jian Qiu Tun Wang Tun Wang Chenzi Yang Chenzi Yang Mo Wang Mo Wang Jiehua Li Jiehua Li Hui Wang Hui Wang Likun Sun Likun Sun Application of a Novel Common-Iliac-Artery Skirt Technology (CST) in Treating Challenge Aorto-Iliac or Isolated Iliac Artery Aneurysms Frontiers in Cardiovascular Medicine aorto-iliac artery aneurysm iliac artery aneurysm internal iliac artery novel technology endovascular aortic surgery |
| title | Application of a Novel Common-Iliac-Artery Skirt Technology (CST) in Treating Challenge Aorto-Iliac or Isolated Iliac Artery Aneurysms |
| title_full | Application of a Novel Common-Iliac-Artery Skirt Technology (CST) in Treating Challenge Aorto-Iliac or Isolated Iliac Artery Aneurysms |
| title_fullStr | Application of a Novel Common-Iliac-Artery Skirt Technology (CST) in Treating Challenge Aorto-Iliac or Isolated Iliac Artery Aneurysms |
| title_full_unstemmed | Application of a Novel Common-Iliac-Artery Skirt Technology (CST) in Treating Challenge Aorto-Iliac or Isolated Iliac Artery Aneurysms |
| title_short | Application of a Novel Common-Iliac-Artery Skirt Technology (CST) in Treating Challenge Aorto-Iliac or Isolated Iliac Artery Aneurysms |
| title_sort | application of a novel common iliac artery skirt technology cst in treating challenge aorto iliac or isolated iliac artery aneurysms |
| topic | aorto-iliac artery aneurysm iliac artery aneurysm internal iliac artery novel technology endovascular aortic surgery |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.745250/full |
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