Anévrismes des Artères Iliaques
Marc Coggia Service de chirurgie vasculaire
Hôpital Ambroise Paré
Boulogne-Billancourt
Anévrismes iliaques: fréquence
Rares: 0.4% to 1.9% des anévrismes.
Prévalence dans la population: 0.03%.
•70% artère iliaque commune •20% artère iliaque interne •10% artère iliaque externe
Anévrismes iliaques: distribution
Anévrismes iliaques: stratégie
< 3cm: echo-doppler/an < 3,5cm: echo-doppler/6 mois < 4 cm: intervention si bon risque opératoire > 4 cm: intervention > 5 cm: intervention rapide (risque rupture+++)
The recommended threshold size of 3 to 4 cm was suggested in the era of open surgical repair…perhaps it is reasonable to readdress the conventional approach of waiting until the iliac aneurysm exceeds 3 cm to repair it.
Anévrismes iliaques: stratégie
≤ 18mm ≥ 25mm 18 mm < < 25mm
aorte coeliaque ≥ 26mm + espérance de vie ≥ 8 ans
tube bifurquée
Artères iliaques
oui non
Artères iliaques et chirurgie d’AAA
Anévrismes iliaques et aorte
Data from this study suggests that limiting treatment to the affected iliac artery in patients with isolated IAA provides satisfactory early and mid-term results.
…increase of aortic diameter of more than 5 mm occurred in less than 15% of the patients…
• Chirurgie conventionnelle
• Chirurgie par coelioscopie
• Endoprothèses couvertes
• Embolisation endoluminale
Anévrismes iliaques: traitement?
Anévrismes iliaques: chirurgie
Operative mortality for elective open repair of isolated iliac artery aneurysm remains as high as 10% in the recent literature, which is significantly greater than open repair of infrarenal abdominal aortic aneurysms
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