Novel Application of Iliac Branch Devices in Treatment of Non-aortoiliac Aneurysmal Pathologies

Iliac branch devices (IBDs) are used for flow preservation in hypogastric arteries while treating aortoiliac, common iliac artery aneurysms. Use of IBDs in non-aortoiliac aneurysmal pathology is seldom reported in the literature. We report our experience and outcomes using IBDs in conditions other than aortoiliac aneurysms. We retrospectively reviewed the institutional database from 2019 to 2022. The patients who required IBDs for aortoiliac, common iliac, and hypogastric artery aneurysms were excluded. Patient demographics, indications for the use of IBDs, and procedural details are described in Table. We also assessed the technical success, endoleaks, device patency, and reintervention rates. Of 92 IBDs implanted during the study period, eight patients were treated for non-aortoiliac aneurysmal pathology. Four were males, and four were females. The mean age was 63.6 years. Four patients had an aortoiliac occlusive disease, of which two had failed aortobifemoral bypass. Three patients had a distal aortic injury with pseudoaneurysm formation, and one had a right subclavian artery aneurysm with the device delivered via the right carotid artery. Technical success was 100%. The mean radiation dose and procedure duration were 1097.7 mGy and 235.2 minutes, respectively. At mean follow-up of 23 months, the primary patency was 100%. None of the patients had endoleaks or required reintervention. The design of the IBD allows its use in the treatment of certain traumatic distal aortic injuries, aortoiliac occlusive disease, and other complex vascular pathologies to overcome anatomical limitations. Case selection is paramount to the success of the procedure.TableDemographics and the procedural details of the study cohortPatient No.SexAge, yearsIndicationDevice size, mm × mm × cmProcedure time, minsRadiation dose, mGyContrast used, mL1M68AIOD23 × 14.5 × 102501232702F64AIOD with occluded AFB graft23 × 10 × 1075312573M38Distal aortic injury with right CIA occlusion23 × 10 × 10243567684F76Aortic bifurcation injury23 × 10 × 1094592525M67Right SCA aneurysm23 × 10 × 1032623111076F59AIOD with occluded AFB graft23 × 10 × 106812579957F72AIOD23 × 10 × 101571075528M65Traumatic distal aortic injury23 × 10 × 105611423AFB, Aortobifemoral bypass; AIOD, aortoiliac occlusive disease; CIA, common iliac artery; F, female; M, male; SCA, subclavian artery. Open table in a new tab