FT8. Iliac Arteries Morphological Features as Predictor of Outcome After Standard EVAR Procedures

This study evaluated the impact of iliac arteries' anatomical features on outcome of elective endovascular repair (EVAR) of abdominal aortic aneurysms (AAAs) in a double-center experience. A retrospective study was conducted on a prospectively collected database between 2010 and 2012. Preoperative DICOM images were reviewed searching for iliac axes' diameters and tortuosity (expressed as ratio between the centreline-assessed length and the straight distance from aortic bifurcation to femoral artery, assessed in coronal projection) and the presence of femoropopliteal steno-obstructive disease as factors potentially influencing outcome. Measures considered for analysis were reintervention and mortality rates during follow-up. Of 289 patients evaluated, 248 were male (85.9%), mean age was 75 ± 7.3. Mean narrowest diameters of common iliac arteries (CIA) were 12.8 ± 4 mm and 12.9 ± 3.9 mm; mean right external iliac artery (EIA) 7.7 ± 1.6 mm and 7.8 ± 1.7 mm, respectively, on the right and left side. Mean tortuosity ratios were 0.8 ± 0.1 (0.4-0.91) and 0.8 ± 0.1 (0.49-0.99) on right and left side, respectively. Femoropopliteal steno-obstructive disease was present in 31 patients (10.7%). Technical success was achieved in all cases. No in-hospital and 30-day complications were recorded. At a mean follow-up of 26 months, 30 reinterventions were required in 26 patients (8.9%), and 22 (7.6%) non-AAA-related deaths were noted. Right EIA diameter ≤5 mm (odds ratio, 5.2; confidence interval, 1.73-15.57; P = .0012), and femoropopliteal steno-obstructive disease (odds ratio, 3.06; confidence interval, 1.02-9.20; P = .03) were significantly related to reinterventions during follow-up. Iliac tortuosity ratio was not a significant predictor of adverse events. Our experience suggests that diameters of access vessels and the presence of femoro-popliteal steno-obstructive disease could affect the outcome of EVAR.