7. 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+++)
8. Anévrismes iliaques: stratégie
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.
9. Artères iliaques et chirurgie d’AAA
Artères iliaques
≤ 18mm 18 mm < < 25mm ≥ 25mm
aorte coeliaque ≥ 26mm
+ espérance de vie ≥ 8 ans
tube non oui bifurquée
10. Anévrismes iliaques et aorte
…increase of aortic diameter of more than 5 mm
occurred in less than 15% of the patients…
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.
14. 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
32. Anévrismes iliaques: conclusion
• Risque de rupture élevé
• Seuil opératoire: 3 cm
• Traitement endovasculaire de première
intention +++
• Chirurgie si compression +++
• Traumatisme opératoire majoré de la
chirurgie ouverte traditionnelle
• Intérêt de la coelioscopie
