Ten-Year Experience with Management of Aortoiliac Aneurysms Using Retrograde Endovascular Internal Iliac Artery Preservation.

Background: To evaluate the use of retrograde endovascular internal iliac artery preservation (REIIAP) technique for treating aortoiliac aneurysms. Methods: We reviewed our database for all patients with aortoiliac aneurysms who underwent REIIAP technique between April 2004 and April 2014. Patients underwent implantation of an Apollo aortomonoiliac (Nano Endoluminal, Florianopolis, Brazil), contralateral implantation of a Viabahn stent graft (Gore Medical, Flagstaff, AZ) positioned from the external iliac artery into the internal iliac arteries as a bridging stent and femorofemoral bypass. The outcomes that we evaluated included technical success, operative mortality and morbidity, endoleak, aneurysm diameter, bridging stent occlusion, and reintervention during follow-up. Results: A total of 21 patients (19 men, mean age 73 +/- 2.3 years) were identified. Technical success was achieved in all cases, and none of the patients died during the follow-up (mean follow-up 52 38.5 months). Type IB endoleak was diagnosed in 2 patients, bridging stent occlusion was diagnosed in 1 patient, and reintervention was required for 2 patients. Diameter regression was observed in the aorta (P = 0.15), left common iliac artery (P = 0.37), and right common iliac artery (P = 1.22). Conclusions: This study demonstrates the feasibility of the REIIAP technique presenting high success rate and similar complication rates compared with other therapeutic options during follow-up. These results demonstrated that it is a useful option for selected patients with aortoiliac aneurysms unfit for other techniques.