腸骨動脈領域におけるTechnical Tips

概要

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Abdominal aortic aneurysm is often associated with aneurysmal dilatation of the common iliac arteries. Iliac artery interventions including coil embolization of internal iliac artery play important roles in endovascular aneurysm repair (EVAR). Also, for treatment of common iliac artery aneurysms, stent-grafting is one of the major treatments with or without coil embolization. In this chapter, technical tips for iliac interventions relevant to stent grafting are described. Use of a guiding sheath and coaxial microcatheter system, detachable fibered microcoils followed by pushable coils, liquid glue mixed with Lipiodol, optimal working angle for identification of the arterial branches and radiation protection for patients and operators are essential. Buttock claudication and erectile dysfunction are frequent complications of internal iliac artery embolization. Occlusion of the proximal internal iliac arterial trunk will be associated with reduced complications compared with distal occlusions. Though not currently approved in Japan, branched endovascular graft preserves blood flow to the internal iliac artery, reducing the potential for ischemic sequelae.
一般社団法人日本インターベンショナルラジオロジー学会の論文