Clinical data, guidelines and real-world outcomes of endovascular iliac aneurysm repair with the GORE® EXCLUDER® Iliac Branch EndoprosthesisProvision of Services for People with Vascular Disease 2021

Abstract

Isolated aneurysms of the iliac arteries are extremely rare. They most frequently occur in the common iliac artery (CIA) and are least frequent in the external iliac artery (EIA).1 Most (95%) affected patients are male and the median age of diagnosis is in the seventh decade of life.2 The underlying pathology of isolated iliac artery aneurysms is similar to that of abdominal aortic aneurysms. This includes degenerative aneurysm, pseudoaneurysm, penetrating ulcer, post-dissection aneurysm mycotic aneurysm, and traumatic aneurysm.3 Unlike patients with abdominal aortic aneurysms, those with iliac artery aneurysms present with symptoms of compression of other structures, particularly the ureter, sacral plexus and iliac veins. Reported growth rate of isolated iliac artery aneurysms is similar to that of abdominal aortic aneurysms. Ruptured isolated iliac artery aneurysms are associated with significant mortality,4 which is higher when treatment is undertaken as an emergency rather than an elective surgical procedure. Effective and timely intervention is therefore essential to improve survival. The aim of surgical treatment is to exclude the aneurysm from the circulation to prevent further growth and rupture. Traditional open surgical repair (OSR) was the mainstay of treatment but is technically challenging due to the location of the aneurysms in the pelvis and a frequent prior history of abdominal aortic aneurysms.1 Endovascular repair (EVAR) of isolated iliac artery aneurysms is a less invasive alternative to OSR. It is performed by a combination of branch-vessel coil embolisation and stent grafting, and has potential advantages over OSR in reducing perioperative morbidity and mortality.5 This supplement is a report of a satellite symposium held during the Vascular Societies' Annual Scientific Meeting in November 2022. It reviews clinical data, guidelines and real-world outcomes of endovascular iliac aneurysm repair with the GORE® EXCLUDER® Iliac Branch Endoprosthesis.