Korean J Vasc Endovasc Surg.
2013 Nov;29(4):121-127. 10.5758/kjves.2013.29.4.121.
Tortuosity Index and Angulation of the Common Iliac Artery in Abdominal Aortic Aneurysm Patients Treated with the Endovascular Technique to Provide Adequate Access Route
- Affiliations
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- 1Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. twkwon2@amc.seoul.kr
- KMID: 1875531
- DOI: http://doi.org/10.5758/kjves.2013.29.4.121
Abstract
- PURPOSE
The tortuosity of the iliac artery and length of the common iliac artery are considered to be limiting factors when performing endovascular aneurysm repair (EVAR). The aim of this study was to determine the anatomical features of the common iliac artery in patients who underwent EVAR.
METHODS
Common iliac artery tortuosity was retrospectively assessed in 144 abdominal aortic aneurysm (AAA) patients (127 men; mean age, 70 years) treated from April 2007 to March 2011. Median luminal centerline measurements of 288 iliac arteries were made on preoperative computed tomography images using a three-dimensional workstation.
RESULTS
The mean aneurysm diameter (+/-standard deviation) was 56.83+/-11.31 mm. The mean tortuosity index was 1.4287+/-0.1808. Five variables were significantly associated with the tortuosity ratio: age (r=0.216, P=0.009), diabetes mellitus (r=-0.215, P=0.010), smoking (r=-0.212, P=0.011), height (r=-0.169, P=0.043), and body mass index (r=-0.215, P=0.010). Procedure time and tortuosity were weakly correlated (r=0.166, P<0.05). Of the 70 cases with EVAR-related complications, there were 19 graft-related complications. There was no correlation found between iliac tortuosity and graft-related complications.
CONCLUSION
A high degree of iliac artery tortuosity can be a limiting factor that increases the procedure time required for endovascular treatment of AAA. Measurement of iliac tortuosity is feasible and clinically meaningful, and its role in relation to human assessment must be further defined.
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