Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Endograft limb occlusion in EVAR: iliac tortuosity quantified by three different indices on the basis of preoperative CTA

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Cutdown Technique is Superior to Fascial Closure for Femoral Artery Access after Elective Endovascular Aortic Repair

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. EJVES, the Leading Journal in Vascular Surgery, is One of the Numerous Scientific Pillars of the ESVS

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Supervised Trainee Led Open Vascular Surgery Procedures Should Be "Part" of Modern Training Curricula!

    Research output: Contribution to journalComment/debateResearchpeer-review

  1. Pressure Difference Estimation in Carotid Bulbs using Vector Flow Imaging - A Phantom Study

    Research output: Contribution to journalConference articleResearchpeer-review

  2. Commentary on Drug-Eluting Technologies

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Palliative Prostate Artery Embolization for Prostate Cancer: A Case Series

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Cutdown Technique is Superior to Fascial Closure for Femoral Artery Access after Elective Endovascular Aortic Repair

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Micro-Lightguide Spectrophotometry (O2C) for Lower Limb Perfusion: Effects of Exercise Walking in Claudicants

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

OBJECTIVE: To assess the incidence and outcome of graft limb occlusions after endovascular aortic repair (EVAR) of abdominal aortic aneurysm (AAA) in a high volume single centre. To quantify iliac artery tortuosity in patients with AAA and correlate this with limb occlusion.

DESIGN: Data were collected consecutively and prospectively, and analyzed retrospectively.

MATERIALS: Patients treated with Zenith bifurcated stent grafts from January 2000 to December 2010 at a tertiary referral vascular unit were analyzed. Routine regular office follow-up with computed tomography angiography (CTA) and, subsequently, duplex ultrasound imaging was performed. Patients with limb occlusions were identified. For each index patient, two controls were obtained, one immediately preceding and one following the index patient in the consecutive cohort of EVAR patients.

METHODS: Demographics and CTA data on limb graft occlusions were recorded and compared with a defined control group. Three different indices were used to describe the tortuosity of the iliac vessels based on preoperative CTA: pelvic artery index of tortuosity (PAI), common iliac artery index of tortuosity (CAI), and a visual description of vessel tortuosity - the double iliac sign (DIS). Demographic data and indices were correlated for later occurring limb occlusion.

RESULTS: 504 patients underwent EVAR and 18 patients experienced graft limb occlusion during a median follow-up of 28 months (range 0-133). Primary graft patency was 97% at 1 year and 96% at 3 years. Logistic regression showed that iliac artery tortuosity (DIS) (p = .001) and body mass index (p = .007) had a significant impact on graft patency.

CONCLUSION: A tortuous vessel on the preoperative CTA is associated with an increased risk of limb occlusion after EVAR. Adjunctive stenting of iliac segments deemed at risk is suggested, which is achieved without compromise of the aneurysm repair.

Original languageEnglish
JournalEuropean journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
Volume48
Issue number5
Pages (from-to)527-33
Number of pages7
ISSN1078-5884
DOIs
Publication statusPublished - Nov 2014

ID: 44891986