Effect of occlusion of the internal iliac artery during endovascular repair of abdominal aortic aneurysm on the occurrence of postoperative pelvic ischemic complications in patients
10.3760/cma.j.cn115396-20240408-00105
- VernacularTitle:腹主动脉瘤腔内修复术中封闭髂内动脉对患者术后发生盆腔缺血性并发症的影响
- Author:
Yanlong HE
1
;
Yue LIANG
Author Information
1. 内蒙古自治区人民医院血管外科，呼和浩特 010017
- Keywords:
Aortic aneurysm, abdominal;
Iliac artery;
Ischemia;
Endovascular aneurysm repair
- From:
International Journal of Surgery
2024;51(7):460-465
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of occlusion of the internal iliac artery during endovascular aneurysm repair(EVAR)of abdominal aortic aneurysm (AAA) on postoperative pelvic ischemic complications in patients.Methods:A retrospective case-control study was conducted to analyze the clinical data of 177 patients with subrenal AAA who received occlusion of the internal iliac artery during EVAR treatment at Inner Mongolia People′s Hospital from January 2018 to October 2023. They were divided into groups A, B, and C based on the occlusion of the internal iliac artery during surgery. Patients in group A ( n=20) involved intraoperative occlusion of bilateral internal iliac artery; patients in group B ( n=75) involved intraoperative occlusion of unilateral internal iliac artery; patients in group C ( n=82) retained bilateral internal iliac artery during surgery. The incidence of pelvic ischemic complications were recorded and compared in three groups of patients after surgery and during follow-up. The measurement data was expressed as mean ± standard deviation ( ± s), and analysis of variance was used for comparison between the three groups; Chi-square test and their continuous correction method were used for comparison between data groups. Results:There was no significant difference in age, gender, tumor diameter, smoking, drinking and complications (hypertension, diabetes, coronary heart disease, cerebral infarction, etc.) among the three groups ( P>0.05). Compared with group B and group C, the incidence of pelvic ischemic complications in group A was significantly increased, and the difference was statistically significant ( P=0.012, 0.007); compared with group C, there was no significant change in the incidence of pelvic ischemic complications in group B, and the difference was not statistically significant ( P>0.05). Conclusions:In the treatment of subrenal AAA with EVAR, the intraoperative bilateral internal iliac artery occlusion is more common than unilateral or bilateral internal iliac artery preservation, and the incidence of postoperative pelvic ischemic complications is significantly increased. It is recommended to preserve the internal iliac artery as much as possible during surgery.
