Objective: To investigate the causes and treatment strategies for iliac limb occlusion following endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA). 
Methods: The clinical data of 130 AAA patients admitted in the Department of Vascular Surgery of Xiangya Hospital, Central South University during January 2016 to July 2018 were retrospectively collected, and the clinical data of those that developed postoperative iliac limb occlusion were analyzed.
Results: Of the 130 AAA patients who successfully underwent EVAR, 6 cases (4.61%) developed postoperative iliac limb occlusion, all of which were unilateral, and the average time to occurrence of occlusion was (55±87) d. The clinical manifestations of the patients mainly were intermittent claudication and rest pain. The treatment methods included embolectomy through a femoral arteriotomy plus femorofemoral bypass in 2 cases, iliac arterial stent placement in one case, and embolectomy through a femoral arteriotomy plus iliac arterial stent placement in 3 cases. The ischemic symptoms of the involved limb disappeared in all patients after operation. Postoperative follow-up was conducted for 12 months and no ischemic symptoms reappeared in any of them.
Conclusion: Iliac limb occlusion is one of the relatively common complications following EVAR, and the reasons include unfavorable features of the aneurysmal neck, iliac stent-graft distortion, and anatomical abnormalities of the distal landing zone of the iliac limb are risk factors for graft limb occlusion. Embolectomy by femoral arteriotomy and/or iliac arterial stent placement are effective treatment approaches.