A Systematic Review on Endovascular Repair of Isolated Common Iliac Artery Aneurysms and Suggestions Regarding Diameter Thresholds for Intervention.

Abstract Objective Our aim is to systematically review results of endovascular aneurysm repair for isolated common iliac artery aneurysms (CIAA) regarding outcomes and to determine if changes should be made to current diameter threshold recommendations for intervention. Methods A comprehensive systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. PubMed, Scopus and Cochrane Central databases were searched. Results Twenty-one studies were deemed eligible and provided data for 879 patients and 981 isolated CIAA treated with endovascular repair. The majority of the patients (90.8%) were males. The weighted mean age of the patients was 71.7 years [range: 37-91]. The weighted mean diameter for the CIAA was 41.1 [15-110] mm and for ruptured aneurysms 58.4 mm. The overall technical success rate was 97.6%. Perioperative mortality rate was 0.7%. Secondary patency rates were reported in only four studies and varied between 96.7% and 100%. The overall morbidity rate was 14%, ranging from 0-25%. Most of the studies did not report long-term or adequate follow-up data. Ruptured of isolated CIAA at Conclusion Endovascular treatment of isolated CIAA is feasible and safe with a low mortality and excellent technical success rates. Consideration of increasing the diameter threshold for intervention of CIAA to 4cm should be considered. Studies with longer follow-up and reliable long-term results are needed.