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ISSN: 2643-6760

Surgery & Case Studies: Open Access Journal

Research Article(ISSN: 2643-6760)

Therapeutic Management of Iliac Anuerysmas are Open Operation Still Indicated?

Volume 6 - Issue 1

Masoud Mirzaie*, Zaur Guliyev and Sheila Fatehpur

  • Author Information Open or Close
    • Department of Vascular Surgery, University Hospital Lemgo, Germany

    Corresponding author:Masoud Mirzaie, Head of the Department of Vascular Surgery University Hospital of Lemgo, Lemgo, Germany

Received:September 24, 2020   Published:October 05, 2020

DOI: 10.32474/SCSOAJ.2020.06.000227

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Abstract

Objective: Isolated aneurysms of the iliac artery are relatively rare (7% of all intra-abdominal aneurysms), but also pose a great therapeutic challenge in combination with aortic aneurysms. As a rule, iliac aneurysms with a size of > 3 cm are treated independently of the abdominal aortic aneurysm, in the interventional setting. In case of contraindications due to anatomical findings and patient-specific contraindications, such patients have to undergo a complex revascularization operation.

Patientsand Methodology:

For this study, between 2007 and 2017, 28 patients with complicated BAA with irrigation of the iliac arteries or with isolated iliac aneurysms in contraindications to interventional therapy underwent surgery. All patients underwent multi-detector row CT with three-dimensional (3D) reformation in 3 mm slices. In addition, peripheral blood flow was determined in all patients by measuring ABI. Primary and secondary outcome of patients was determined after 30 days, after 3 months, and then every 6 months.

Results: The extension of the aneurysm of the a. iliaca required in all cases the implantation of a Y-prosthesis, in 22 cases bifemoral, in 4 cases biiliac, in 2 cases with unilateral aneurysm of the a. iliac, unilateral anastomosis iliac and 2nd anastomosis femoral. In 26 cases an internal iliac artery revascularization was performed, in 3 cases even both arteries. Iliacae internae. The interponent to the revascularizing internal iliac artery was always implanted in the opposite leg of the Y-prosthesis. In 2 cases the internal iliac artery was unilaterally ligated and the reciprocal internal iliac artery revascularized. In 4 cases, the inferior mestric artery was reimplanted in the left prosthesis leg, in 3 cases, with revascularization of both arteries. Iliacae internae ligated. In 21 patients this was closed. To illustrate the surgical techniques

Conclusion: One of the patients with a perforated aneurysm of the internal iliac artery died of urosepsis shortly after his discharge, all other patients survived the operation very well. Postoperativegluteal ischemia did not occur in any of the patients. The duplex sonographic anastomoses to internal iliac artery were inconspicuous to date. Postoperative mesenteric ischemia did not occur in patients with ligature of the internal mesenteric artery. The surgical procedure presented here, which is adapted to the anatomic conditions of each patient, represents a demanding form of therapy which, in case of contraindications to conventional therapy, represents the only possibility for the treatment of such patients.

Keywords: Open surgery, ilical aneuryms

Abstract| Introduction| Material and Methods| Results| Discussion| Conflict of Interest| References|

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