Unit:
Speciality Endovascular TechniquesLibrary of the School of Health Sciences
Author:
Doukogianni Iliana
Supervisors info:
Γεώργιος Γερουλάκος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Καθηγητής Ιωάννης Κακίσης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Καθηγητής Αχιλλέας Χατζηϊωάννου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Preservation of internal iliac artery with Iliac Banch Devices during endovascular management of aortoiliac aneurysms: A systematic review and meta-analysis
Translated title:
Preservation of internal iliac artery with Iliac Banch Devices during endovascular management of aortoiliac aneurysms: A systematic review and meta-analysis
Summary:
Background: Aortoiliac aneurysms represent up to 40% of all abdominal aortic aneurysms. Although hypogastric exclusion is widely used, the risks of pelvic ischemia and morbidity rates are high. Several techniques have been developed in order to preserve the internal iliac artery and overcome these problems. This systematic review and meta-analysis aims to evaluate the safety and efficacy of iliac branch devices (IBDs) in preserving IIA flow during the management of aortoiliac aneurysms.
Methods: A systematic literature search was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, identifying eligible studies published from January 1998 to May 2024. A total of 43 studies involving 2,134 patients were included, focusing on the outcomes of IIA preservation using IBDs. Key clinical outcomes of our meta-analysis were technical success rates, 30-day and overall mortality, 30-day patency, follow-up patency, endoleaks, reintervention, and buttock claudication.
Results: The findings indicate a high technical success rate of 97.06% (95% CI: 95.45% – 98.40%) for IBDs, with a negligible 30-day mortality rate of 0.01% (95% CI: 0.00% – 0.23%). Both 30-day and follow-up patency rates were exceptionally high at 99.34% (95% CI: 98.69% – 99.80%) and 97.41% (95% CI: 96.36% – 98.33%), respectively. However, the incidence of type II endoleaks was notable at 16.37%(95% CI: 11.81% – 22.08%), while type I and type III endoleaks were less frequent. Complications were minimal, with buttock claudication related to IBD occlusion, occurring in only 0.65% (95% CI: 0.19% – 1.29%) of patients.
Conclusion: The use of iliac branch devices for the preservation of internal iliac artery flow during aortoiliac aneurysm repair is both safe and effective, significantly reducing the risk of pelvic ischemia. Careful preoperative planning and anatomical assessment are essential to optimize patient outcomes. Further studies with extended follow-up are essential to confirm the long-term durability and effectiveness of this approach.
Main subject category:
Health Sciences
Keywords:
Iliac branch devices, IBD, Iliac artery preservation, Aortoiliac aneurysms
