Introduction and objective:

occlusive arterial disease involving the iliac arteries can be cause of complications in EVAR. Its frequency is not high, but its mortality is and there is scant evidence regarding its repercussion in complex EVAR. The use of iliofemoral conduits is a tool to overcome this problem. Our objective is to analyze the impact of the use of iliofemoral conduits in the neurological and vascular morbimortality associated with FEVAR and BEVAR.

Materials and methods:

retrospective recollection of patients who underwent elective FEVAR or BEVAR for juxtarrenal, thoracoabdominal aneurysms or type IA endoleak between 2014 and 2020 in one institution (Clínica La Sagrada Familia, Buenos Aires, Argentina). Patients were divided in two groups, one with conduits (group A) and one without (group B). Group A was subdivided between those who received temporary conduits and those with permanent conduits.

Results:

we analyzed 45 patients. 23 received conduits (group A) whereas 22 did not (group B). Mean age was 73 years and mean sac diameter was 69.89 mm. Mean hospital stay was 4.7 days. Group A presented more patients with peripheral vascular disease (56.5 % vs. 22.7 %, p = 0.045) and smaller iliac arteries. There were 8 complications in the perioperative period (17.8 %; group A, n = 1, 4.3 %; group B, n = 7, 31.8 %. p = 0.043). 2 patients died, leaving a perioperative mortality of 4.4 % (group A 0 % vs. group B 9.1 %, p = 0.45). Complications included spinal cord ischemia, iliac artery rupture and lower limb ischemia. In group A, 12 (52.2 %) patients received permanent conduits and 11 (47.8 %) temporary conduits.

Conclusions:

the use of iliofemoral conduits in FEVAR and BEVAR is safe when they are part of the preoperative planning. Neurological and vascular complications are not infrequent and carry a high mortality. The use of conduits is effective to reduce its incidence and associated mortality.

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