Methods: This study included a total of 119 patients (100 males, 9 females; mean age 69.4 years; range 52 to 93 years) who underwent endovascular aortic repair between January 2007 and June 2014. The iliac artery morphology problems were evaluated. Morphologies were classified as normal, aneurysmal lesions, stenosis, tortuosity, and dissection. The placement of the main body of the stent graft and the contralateral limb was defined as the main procedure. Additional procedures included intraoperative supportive procedures which were performed due to iliac artery lesions during the procedure. Procedures, challenges, and solutions due to the iliac artery morphology were retrospectively analyzed.

Results: Iliac artery morphology was normal in 22 patients. Sixty-two patients had an aneurysmal lesion, 28 patients had stenosis, 45 patients had tortuosity, and two patients had dissection. The main procedure was sufficient in 27 patients. Intraoperative supportive procedures were required in 92 patients. Additional procedures were applied to 17 patients for complications due to the intraoperative supportive procedures. A surgical intervention was required in three patients, since the complication was unable to be solved by additional procedures.

Conclusion: Being aware of iliac artery morphology has increasingly become a prerequisite for vascular surgeons to gain problem-solving skills in case of complications and to be able to apply intraoperative supportive procedures.