Abstract
This study investigated anatomical and procedural factors influencing iliac limb migration and its correlation with late type 1b and type 3 endoleaks. We analyzed 141 iliac limbs from 91 patients who underwent endovascular aneurysm repair for abdominal aortic aneurysm between 2005 and 2017. Iliac limb migration was measured using initial and follow-up computed tomography angiography scans conducted at least three years post-procedure, with significant migration defined as a change of ≥ 5 mm. The iliac limbs were categorized based on the presence of significant migration, and statistical analyses were conducted to compare anatomical and procedural factors between the groups. Significant migration was associated with larger preoperative common iliac artery (CIA) diameters, more acute iliac angles, lower iliac seal degrees, and smaller iliac limb oversizing. Multivariable analysis confirmed that significant migration correlated with larger CIA diameters and lower iliac limb oversizing. Significant iliac limb migration was associated with a higher risk of type 1b endoleak development, while type 3 endoleaks were not observed. Our findings suggest that careful iliac limb oversizing is essential for patients with a CIA diameter > 20 mm, and vigilant monitoring of the iliac landing zone is crucial during postoperative surveillance.