Buttock claudication after interventional occlusion of the hypogastric artery--a mid-term follow-up

Vasc Endovascular Surg. 2012 Apr;46(3):236-41. doi: 10.1177/1538574411436329. Epub 2012 Mar 22.

Abstract

Background: Interventional occlusion of the hypogastric artery (HA) can be used for endovascular aneurysm repair (EVAR) in the iliac arteries. Most frequent ischemic complication is buttock claudication (BC).

Aim: To investigate the frequency and progression of BC after interventional occlusion of the HA prior to EVAR.

Methods: A retrospective analysis was performed in patients with EVAR and occlusion of the HA between September 2004 and August 2010. Acute and persistent BC symptoms were assessed.

Results: Fifty-four catheter occlusions of the HA were performed. In 10 cases, claudication could not be evaluated. During a mean follow-up of 17 months, 23 occlusions (52.3%) of the HA showed BC, in 52% symptoms were persistent. Of the 5 patients, 3 patients who underwent bilateral occlusion had BC and in 2 cases, persistent in the follow-up.

Conclusion: Buttock claudication after occlusion of the HA prior to EVAR is a frequent complication, which often persists during follow-up. Alternatives that maintain pelvic perfusion should be considered.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Aneurysm, Abdominal / surgery*
  • Blood Vessel Prosthesis Implantation / adverse effects*
  • Blood Vessel Prosthesis Implantation / mortality
  • Buttocks / blood supply*
  • Embolization, Therapeutic / adverse effects*
  • Endovascular Procedures / adverse effects*
  • Endovascular Procedures / mortality
  • Female
  • Germany
  • Humans
  • Iliac Aneurysm / diagnostic imaging
  • Iliac Aneurysm / mortality
  • Iliac Aneurysm / surgery*
  • Intermittent Claudication / diagnosis
  • Intermittent Claudication / etiology*
  • Intermittent Claudication / mortality
  • Intermittent Claudication / therapy
  • Male
  • Middle Aged
  • Pelvis / blood supply*
  • Radiography
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome