<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-706X</journal-id>
<journal-title><![CDATA[Angiologia e Cirurgia Vascular]]></journal-title>
<abbrev-journal-title><![CDATA[Angiol Cir Vasc]]></abbrev-journal-title>
<issn>1646-706X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Angiologia e Cirurgia Vascular]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-706X2021000300232</article-id>
<article-id pub-id-type="doi">10.48750/acv.444</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Single center real-world analysis of the use of iliac branched devices for aorto-iliac aneurysm repair]]></article-title>
<article-title xml:lang="pt"><![CDATA[Análise real unicentrica do uso de dispositivos ramificados iliacos para reparação de aneurismas aorto-iliacos]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[Marta Romão]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Melo]]></surname>
<given-names><![CDATA[Ryan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Garrido]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silvestre]]></surname>
<given-names><![CDATA[Luís]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernandes]]></surname>
<given-names><![CDATA[Ruy Fernandes e]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martins]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pedro]]></surname>
<given-names><![CDATA[Luis Mendes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar Universitário Lisboa Norte Hospital de Santa Maria Serviço de Angiologia e Cirurgia Vascular]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>09</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>09</month>
<year>2021</year>
</pub-date>
<volume>17</volume>
<numero>3</numero>
<fpage>232</fpage>
<lpage>237</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-706X2021000300232&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-706X2021000300232&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-706X2021000300232&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Endovascular repair of aortic aneurysms is widely established. However, aorto-iliac aneurysms pose a challenge, specifically regarding distal sealing. A frequent approach is extending the iliac limb to the external iliac artery (EIA) with occlusion of the internal iliac artery (IIA), often with varying degree of pelvic ischemia causing significant morbidity. Iliac branched devices (IBD) allow for the creation of distal landing zones in the EIA and IIA, maintaining pelvic perfusion. We performed a descriptive analysis and outcome evaluation of IBD use in a single center patient cohort.  Methods:  An observational, descriptive, retrospective cohort analysis of all consecutive patients intended to treat with IBDs from Jan-2008 to Dec-2020 was performed. Technical success was defined as correct implantation of the IBD with confirmed patency of both EIA and IIA. We included all patients where at least one IBD was deployed, irrespective of additional procedures. Statistical analysis was performed using STATA 16, for Mac.  Results:  Of the initial 54 patients, 53 were included, (technical success 98,1%). Fifty-two were men (98.2%), mean age 73.5 years (SD 8.1). Mean aortic diameter was 56.4mm (SD 13.4), mean CIA aneurysm diameter 37.0mm (SD 12.7). A total of 60 IBD&#8217;s were performed (CookÆ Medical&#8217;s ZBIS device), of which 5 as part of complex aortic treatment with fenestrated endografts, 32 EVAR with unilateral IBD, 7 EVAR with bilateral IBD, 6 EVAR with unilateral IBD and contralateral extension to the EIA with embolization of the IIA and 3 isolated IBD (for type 1B endoleaks following EVAR or isolated iliac aneurysm). Peri-operative complications included acute kidney injury (AKI) (11,3% - 5/44), paraparesis and intestinal ischemia (1,9% each), one embolic intra-operatory stroke (1,9%) and one acute myocardial infarction (MI) (1,9%). Median follow-up was 9 months (IQR:16, 1-80months), during which 4,9% (2/42) developed type IB endoleaks, 4,9% (2/42) iliac aneurysm enlargement, 2,4% (1/42) limb kinking, 4,9% (2/42) limb occlusion, with a 7,14% (3/42) re-intervention rate. We found no association between limb patency and single, dual-antiplatelet treatment or anti-coagulation (p=0,6). There was no significative difference in AKI incidence between bilateral or unilateral IBD (irrespective of contra-lateral procedure). No in-hospital mortality was registered. There was one case of in-hospital death post-MI (1,9%), overall mortality 17% (9/53).  Conclusion:  In this cohort we found that the most common complication is AKI, apparently not directly related to the technique itself. Follow-up complications were few and mainly associated to loss of distal seal or limb occlusion, but implying a considerable re-intervention rate.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  A reparação endovascular dos aneurismas aórticos está amplamente estabelecida. No entanto, os aneurismas aorto-ilíacos representam um desafio, especificamente no que diz respeito à selagem distal. Uma abordagem frequente é a extensão do ramo ilíaco à artéria ilíaca externa (AIE) com oclusão da artéria ilíaca interna (AII), com grau variável de isquemia pélvica associada a morbilidade significativa. Os Iliac branched devices (IBD) permitem a criação de landing zones distais na AIE e AII, mantendo a perfusão pélvica. Realizámos uma análise descritiva e de avaliação dos resultados do uso de IBD numa coorte de doentes de um único centro.  Métodos:  Foi realizada uma análise retrospectiva, observacional, e descritiva de um coorte de todos os doentes propostos para abordagem com IBDs de janeiro de 2008 a dezembro de 2020. O sucesso técnico foi definido como a implantação correta do IBD com permeabilidade confirmada de ambas as AIE e AII. Incluímos todos os pacientes nos quais pelo menos um IBD foi implantado, independentemente de procedimentos adicionais.  Resultados:  Dos 54 pacientes identificados, 53 foram incluídos (sucesso técnico 98,1%). Cinquenta e dois eram homens (98,2%), com idade média de 73,5 anos (DP 8,1). O diâmetro aórtico médio foi de 56,4 mm (DP 13,4), o diâmetro médio do aneurisma da AIC foi de 37,0 mm (DP 12,7). Um total de 60 IBDs foram realizados (dispositivo ZBIS da Cook® Medical), dos quais 5 como parte do tratamento complexo da aorta com endopróteses fenestradas, 32 EVAR com IBD unilateral, 7 EVAR com IBD bilateral, 6 EVAR com IBD unilateral e extensão contralateral à AIE com embolização da AII e 3 IBD isolados (para endoleaks tipo 1B após EVAR ou aneurisma ilíaco isolado). As complicações perioperatórias incluíram lesão renal aguda (LRA) (11,3% - 5/44), paraparesia e isquemia intestinal (1,9% cada), um acidente vascular cerebral embólico intra-operatório (1,9%) e um enfarte agudo do miocárdio (EAM) (1,9%). O acompanhamento médio pós-operatório foi de 9 meses (IIQ: 16, 1-80 meses), durante o qual 4,9% (2/42) desenvolveram endoleaks tipo IB, 4,9% (2/42) aumento do aneurisma ilíaco, 2,4% (1/42) kinking do ramo, 4,9% (2/42) oclusão do ramo, com taxa de re-intervenção de 7,14% (3/42). Não encontrámos uma associação com significado estatístico entre a permeabilidade de ramo e terapêutica com anti-agregação simples, dupla, ou anticoagulação (p = 0,6). Não houve diferença significativa na incidência de LRA entre IBD bilateral ou unilateral (independentemente do procedimento contra-lateral). Nenhuma mortalidade hospitalar foi registada. Houve um óbito hospitalar pós-EAM (1,9%), mortalidade global de 17% (9/53).  Conclusão:  A complicação mais frequente encontrada na avaliação deste coorte foi a LRA, aparentemente sem relação direta com a técnica em si. As complicações no seguimento foram poucas e principalmente associadas à perda do selagem distal ou por oclusão de ramo, implicando uma taxa de reintervenção considerável.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Iliac-Branch-Device]]></kwd>
<kwd lng="en"><![CDATA[Aorto-iliac aneurysm]]></kwd>
<kwd lng="en"><![CDATA[Iliac aneurysm]]></kwd>
<kwd lng="en"><![CDATA[Cohort]]></kwd>
<kwd lng="en"><![CDATA[Iliac artery preservation]]></kwd>
<kwd lng="en"><![CDATA[EVAR]]></kwd>
<kwd lng="en"><![CDATA[IBD]]></kwd>
<kwd lng="pt"><![CDATA[Iliac-Branch-Device]]></kwd>
<kwd lng="pt"><![CDATA[Aneurisma aorto-ilíaco]]></kwd>
<kwd lng="pt"><![CDATA[Aneurisma ilíaco]]></kwd>
<kwd lng="pt"><![CDATA[Coorte]]></kwd>
<kwd lng="pt"><![CDATA[Preservação da artéria ilíaca]]></kwd>
<kwd lng="pt"><![CDATA[EVAR]]></kwd>
<kwd lng="pt"><![CDATA[IBD]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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