Outcomes after stand-alone use of Gore Excluder Iliac Branch Endoprosthesis for endovascular repair of isolated iliac artery aneurysms.

INTRODUCTION: The aim of our study was to describe outcomes of stand-alone use (i.e. without concomitant implantation of an aortic stent-graft) of the Gore Excluder Iliac Branch Endoprosthesis (IBE) for elective endovascular repair of isolated iliac artery aneurysms. METHODS: We evaluated all consecutive patients electively treated for isolated iliac artery aneurysms using stand-alone Gore Excluder IBE (January 2014 - December 2018). Early (I.e. 30-day) endpoints were technical success, mortality, major adverse events (MAEs), and major access-site complications. Late endpoints were survival, freedom from aortic-related mortality (ARM), internal iliac artery (IIA) primary patency, IIA branch instability, graft-related adverse events (GRAEs), secondary interventions, endoleaks (ELs), aneurysm sac behaviour, and new-onset buttock claudication (BC). RESULTS: A total of 11 consecutive patients (10 males; median age 75 years) were included. Technical success rate was 100%. At 30 days, mortality, MAEs, and major access-site complications were all 0%. Survival and freedom from ARM were 91% and 100%, respectively: only one non-aortic related death was recorded during follow-up. At a median follow-up of 14 months, IIA primary patency, IIA branch instability, and GRAEs were 100%, 0% and 0%, respectively. No instances of graft migration >/=10mm were detected. No graft-related secondary interventions were recorded, and two patients required a procedure-related secondary intervention 3 months after the index procedure (one CFA endarterectomy; one EIA stenting). While new-onset type 1 or type 3 ELs were never noted, one patient developed a new-onset type 2 EL. Aneurysm sac regression >/=5mm) was noted in 6 patients (55%), while in the remaining ones the sac size was stable. No instances of new-onset BC were noted. CONCLUSION: Use of stand-alone Gore Excluder IBE for elective endovascular repair of isolated iliac artery aneurysms is a safe, feasible and effective treatment option. These results may support use of the technique as an effective means of endovascular reconstruction in patients with suitable anatomy.