ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Requirement of intraoperative supportive procedures and complications in infrarenal abdominal aortic aneurysms due to iliac artery morphology
Tonguç Saba1, Enes Duman2, Cevahir Haberal1, Ali Tünel3, Mehmet Özülkü4
1Department of Cardiovascular Surgery, Başkent University Alanya Application and Research Center, Antalya, Turkey
2Departments of Radiology, Başkent University Konya Application and Research Center, Konya, Turkey
3Department of Cardiovascular Surgery, Başkent University Adana Dr. Turgut Noyan Application and Research Center, Adana, Turkey
4Departments of Cardiovascular Surgery, Başkent University Konya Application and Research Center, Konya, Turkey
DOI : 10.5606/tgkdc.dergisi.2017.13191
Background: This study aims to evaluate the problems due to the iliac artery morphology which can lead to technical difficulties and complications during the access and the main procedure of the endovascular aortic repair applied in infrarenal abdominal aortic aneurysms.

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.

Keywords : Aorta aneurysm; endovascular aortic repair; iliac artery morphology
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