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ABS20191120_0001
Aorta Disease and Intervention
The Western Australian Experience with the Gore Excluder Iliac Branch Device for Common Iliac Artery Aneurysm: Technical and Intermediate Outcomes
Kishore Sieunarine1, Daniel Magee2
Royal Perth Hospital, Australia1, Sir Charles Gairdner Hospital, Australia2
Background:
The aim of this study is to assess the safety and the mid-term results of endovascular treatment of common iliac artery (CIA) aneurysms using the GOREEXCLUDER iliac branch endoprosthesis (IBE) device, which has the following advantages: Flexible own internal iliac extension branch, Low profile delivery(16F),Pre-cannulated internal iliac gate design and repositional two stage GORE¢ç SIM-PULL Delivery System
Methods:
The study is a prospective follow-up nonrandomized, single arm multi-institution evaluation. Patients with a CIA aneurysm with or without an aortic aneurysm who underwent endovascular treatment with the Gore IBE were included. Anatomic and procedural data were collected. Computed tomography angiography (CTA) was performed within 30 days after the procedure and at 6 months and yearly intervals when indicated. Ultrasound surveillance was the alternative when CT was contraindicated.
Results:
From May 2015 to January 2019, 55 patients with aneurysmal CIA (mean age 75.5years old) underwent consecutive endovascular treatment with the Gore IBE. The mean follow-up was 20 months. Associated abdominal aortic aneurysm (AAA) in 19 patients, with bilateral CIA aneurysm present in 15 patients. Internal iliac embolization was performed in 5 patients No perioperative endograft complications were observed. 96% two-year branch patency was noted (1 required balloon expandable stenting in the internal and external iliac artery orifice for stenosis, another patient requiring femoral-femoral bypass graft for occlusion Table 1Median ASA classfication (range)           3 (2-4)Procedure duration (mins)                  126 (SD 39.4)Screening time (mins)                        45.3(SD 16.4)Radiation dose (uGym2)                     102119.7(SD 148618.8)CContrast Iodine                                            61%Carbon dioxide                                 6%Carbon dioxide + Iodine                     33%AccessAccess                 Femoral                                          96%Brachial                                          4%AnesthesiaGeneral anesthesia                                      73%Regional anesthesia                         25%Local infiltration                                2%FOLLOW UP DATATable 2OutcomesTechnical success                              88%Conversion to open                                         0Median Length of stay (days)Intensive care unit                            1(0 – 4)Hospital                                          3(1-57)EndoleakType 1                                            1Type 2                                            12Type 3                                            1Mortality 30d                                    0Buttock claudication                           7
Conclusion:
The technical success and mid-term results demonstrate encouraging results and clinical benefits of the GORE EXCLUDER IBE. The prospective Western Australia Registry is continuing to provide longer follow-up as this is needed to assess long-term results.
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