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Internal Iliac Artery Embolization Before Endovascular Repair of Abdominal Aortic Aneurysms

Frequency, Efficacy, and Clinical Results

¹ Department of Angiography and Interventional Radiology, AKH-University Clinics, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
² Department of Surgery, Barmherzige Schwestern, Stumpergasse 6, A-1060 Vienna, Austria.
³ Department of Vascular Surgery, AKH-University Clinics, A-1090 Vienna, Austria.
⁴ Ludwig Bolzmann Institute of Vascular Medicine, A-1090 Vienna, Austria.

View larger version (11K): [in a new window]   Fig. 1A. —Drawings of EUROSTAR classification of abdominal aortic aneurysms [21]. Type A, proximal and distal aortic necks longer than 15 mm and less than 25 mm in diameter.

View larger version (11K): [in a new window]   Fig. 1B. —Drawings of EUROSTAR classification of abdominal aortic aneurysms [21]. Type B, proximal aortic neck longer than 15 mm and less than 25 mm in diameter, reaching aortic bifurcation, with common iliac arteries less than 12 mm in diameter.

View larger version (11K): [in a new window]   Fig. 1C. —Drawings of EUROSTAR classification of abdominal aortic aneurysms [21]. Type C, proximal aortic neck as type A aneurysm, including aortic bifurcation, with common iliac arteries less than 12 mm in diameter.

View larger version (11K): [in a new window]   Fig. 1D. —Drawings of EUROSTAR classification of abdominal aortic aneurysms [21]. Type D, proximal aortic neck as described in type A, with aneurysmatic dilatation of one common iliac artery extending into iliac bifurcation, or with a common iliac artery diameter greater than 12 mm.

View larger version (12K): [in a new window]   Fig. 1E. —Drawings of EUROSTAR classification of abdominal aortic aneurysms [21]. Type E, proximal aortic neck as described in type A, with aneurysmatic dilatation of both common iliac arteries extending into iliac bifurcation, or with a common iliac artery diameter greater than 12 mm.

View larger version (115K): [in a new window]   Fig. 2A. —69-year-old man with abdominal aortic aneurysm and one common iliac artery aneurysm, including iliac bifurcation (EUROSTAR type D). Bifurcated stent-graft will be placed, but it must extend into external iliac artery. Arteriogram of right internal iliac artery before coil embolization by means of Sidewinder-Simmons-I catheter (Cordis-Johnson & Johnson, Roden, The Netherlands).

View larger version (120K): [in a new window]   Fig. 2B. —69-year-old man with abdominal aortic aneurysm and one common iliac artery aneurysm, including iliac bifurcation (EUROSTAR type D). Bifurcated stent-graft will be placed, but it must extend into external iliac artery. Angiogram shows incomplete thrombosis of internal iliac artery (arrow) immediately after placement of nine Gianturco coils (Cook, Bloomington, IN) above internal iliac bifurcation.

View larger version (121K): [in a new window]   Fig. 2C. —69-year-old man with abdominal aortic aneurysm and one common iliac artery aneurysm, including iliac bifurcation (EUROSTAR type D). Bifurcated stent-graft will be placed, but it must extend into external iliac artery. Arteriogram shows complete thrombosis (arrow) of internal iliac artery a few minutes after completion of coil embolization.

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