Risk Factors Of Complications After Closure Of The Internal Iliac Artery By EVAR Surgery For Abdominal Aortic Aneurysm

Objective: To investigate the risk factors of related complications occurring after unilateral closure of the internal iliac artery(IIA)by EVAR surgery for abdominal aortic aneurysm(AAA).Methods: 73 patients with AAA,who were subjected to EVAR surgery to close the internal iliac artery(IIA)on one side in the Vascular Surgical Department of the Affiliated Hospital of North Sichuan Medical College between March 2012 and October 2018,were included in the study.28 of the patients suffered from related postoperative complications(complication group)and 45 did not(common group).Univariate analysis and multivariate analysis were used to compare the clinical and imaging data between the two groups.The binary logistic regression analysis was used to investigate the risk factors of complications,and the ROC curve analysis of variables was used to predict the risk of complications and find the optimal critical value.Results: The indicators with statistical significance(binary logistic model)included: closure of IIA on a different side [odds ratio(OR)=6.776;95% confidence interval(95% CI),1.783-25.760;P=0.005];NCIIA branch number(OR,32.860;95% CI,0.086-0.620;P=0.011);missing or not of the ascending branch of the deep femoral artery(OR,0.133;95% CI,0.037-0.480;P=0.002].Analysis of the ROC curve suggests that the number of NCIIA branches(area under the curve = 0.712)is more accurate for predicting related complications after closure of the internal iliac artery by EVAR surgery.Conclusion: Closure of the IIA on the left side,small number of NCIIA branches and lack of ascending branches of the deep femoral artery were independent risk factors of related complications occurring after unilateral closure of the internal iliac artery by EVAR surgery for the patients with AAA.Preference to reserve of the left IIA might reduce the incidence of postoperative complications.