Internal iliac occlusion without coil embolization during XXXX repair.

@entity1 @entity1070 @entity39 @entity63 @entity439 @entity613 @entity1029 @entity1028
PURPOSE: When @entity1028 and common iliac artery (CIA) @entity439 undergo concomitant endovascular repair, endograft limb extension into the external iliac artery is often necessary. Usually, the internal iliac artery (IIA) is coil embolized in such a case to prevent @entity1070 . It has been our practice to coil embolize the IIA only in cases where there is not adequate stent graft seal in the CIA immediately proximal to the IIA origin (effectively sealing the entire IIA origin). In this study, we evaluated the outcomes of this approach. METHODS: We retrospectively reviewed 204 consecutive @entity1028 at Dartmouth-Hitchcock Medical Center from 1996 to 2001. Computed tomographic angiography with three-dimensional reconstruction was the primary preoperative imaging modality, and the decision to cover the IIA without concomitant coil embolization was based before surgery on the presence of adequate graft oversizing (> or =10% to 15%) in the most distal 5 mm of CIA and 15 mm of proximal external iliac artery, respectively. RESULTS: The IIA was occluded 33 times in 31 @entity1 . In 22 cases (67%), the IIA was covered without coil embolization (COVER group). The remaining 11 @entity1 (33%) with inadequate graft oversizing in the CIA underwent IIA coil embolization (COIL group). The follow-up periods for the COVER and COIL groups were 19 +/- 2 months and 10 +/- 3 months, respectively. All operations in both groups were technically successful without evidence of @entity1070 at completion angiography. No endoleaks, graft migrations, or @entity439 were associated with the covered or coiled IIAs during the follow-up period. No clinical sequelae were seen in the COVER group, with the exception of @entity613 in six @entity1 (27%) that resolved completely in five @entity1 . In the COIL group, five @entity1 (45%) had @entity613 . In addition, one case of buttock @entity39 and one case of @entity63 occurred in the COIL group. CONCLUSION: Covering the IIA without coiling effectively excluded the @entity1029 in every case and was associated with a low incidence rate of complications compared with coil embolization. With detailed preoperative imaging and @entity1 selection, IIA coil embolization may not be necessary in as many as two thirds of @entity1 who need IIA occlusion.
