Background:Limited data is available on the use of a polyester graft limb with a helical stent configuration deployed in the external iliac artery (EIA) during endovascular aneurysm repair (EVAR), so we prospectively analyzed the efficacy of the Zenith Spiral-Z limb deployed in the EIA.

Methods and Results:Patients undergoing EVAR using a Zenith stent-graft and Spiral-Z limb deployed in the EIA were prospectively registered in 24 Japanese institutions from June 2017 to November 2017. In total, 65 patients (74 limbs) (mean age: 77.1±8.0 years, 87.7% men, mean abdominal aortic aneurysm (AAA) diameter: 51.9±7.2 mm, mean iliac artery aneurysm (IAA) diameter: 38.3±10.0 mm) were registered and followed up. The most common reason for deployment in the EIA was a common IAA (43 limbs, 58.1%), and 8 limbs (10.8%) had a bare nitinol stent placed at the Spiral-Z limb. A total of 61 patients (70 limbs) completed a 24-month follow-up. There were 2 Spiral-Z limb stenoses and 1 occlusion, leading to a primary patency of 95.5% and a secondary patency of 100%, at 24 months. Buttock claudication occurred in 24.3% of the limbs treated at 1 month but decreased to 4.3% at 24 months.

Conclusions:Our multicenter prospective study showed that Spiral-Z limb deployed in the EIA was associated with satisfactory results and seems to be a durable option, even in the era of iliac branch devices.

背景：关于在血管内动脉瘤修复 (EVAR) 期间使用在髂外动脉 (EIA) 中部署的螺旋支架配置的聚酯移植肢体的数据有限，因此我们前瞻性地分析了部署的 Zenith Spiral-Z 肢体的功效在环境影响评估中。

方法和结果：从 2017 年 6 月到 2017 年 11 月，在 EIA 中使用 Zenith 支架移植物和 Spiral-Z 肢体进行 EVAR 的患者在 24 家日本机构进行了前瞻性登记。 总共 65 名患者（74 条肢体）（平均年龄：77.1±8.0 岁， 87.7% 的男性，平均腹主动脉瘤 (AAA) 直径：51.9±7.2 毫米，平均髂动脉瘤 (IAA) 直径：38.3±10.0 毫米）被登记和随访。在 EIA 中部署的最常见原因是常见的 IAA（43 个肢体，58.1%），并且 8 个肢体（10.8%）在 Spiral-Z 肢体处放置了裸镍钛合金支架。共有 61 名患者（70 条肢体）完成了 24 个月的随访。在 24 个月时，有 2 处 Spiral-Z 肢体狭窄和 1 处闭塞，导致 95.5% 的主要通畅率和 100% 的次要通畅率。24.3% 的肢体在 1 个月时出现臀部跛行，但下降到 4。

结论：我们的多中心前瞻性研究表明，在 EIA 中部署的 Spiral-Z 肢体与令人满意的结果相关，并且似乎是一种持久的选择，即使在髂支装置时代也是如此。