Abstract:Objective: To investigate the method of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) combined with iliac artery aneurysm. Methods: The clinical data of 35 patients with AAA and concomitant iliac artery aneurysm undergoing EVAR from August 2007 to March 2014 were retrospectively analyzed. The patients consisted of 9 cases complicated with unilateral internal iliac artery aneurysm, one case with bilateral internal iliac artery aneurysm, 14 cases with unilateral common iliac artery aneurysm (diameter larger than 18 mm) and 11 cases with bilateral common iliac artery aneurysm. The endovascular procedures performed included internal iliac artery embolization followed with stent coverage, simple stent coverage of the internal iliac artery aneurysm, use of a braided stent, and Sandwich technique for internal iliac artery endorevascularization. Results: All endovascular procedures were successfully performed, with an average operative time of (125± 40) min and blood loss of (173±65) mL. Intraoperative endoleak was observed in 8 patients (22.9%), including type I endoleak in 4 cases (2 from the proximal and 2 from the distal attachment site) which were all resolved after balloon dilatation, type III endoleak in one case which was resolved by dilatation plus adjunctive coil embolization, type II endoleak in 2 cases and type IV endoleak in one case, none of which received further intervention. Postoperative follow-up was conducted for 6 to 26 months in the 35 patients, during which time no aneurysmal rupture occurred; AAA enlargement was found in 2 cases 6 months after procedure, which was identified as distal type I endoleak by radiography and resolved by coil embolization, and no aneurysmal enlargement occurred in any of the remaining 33 cases. Conclusion: Ideal short-term results may be obtained in patients with AAA and concomitant iliac artery aneurysm by appropriate treatment of the internal iliac artery and then suitable endovascular techniques according to the diameter of the common iliac artery.