OBJECTIVES: Rupture of common iliac or aortoiliac aneurysm is fatal in more than eight out of 10 cases. Main objectives were to describe inhospital management and estimate morbidity/mortality in patients implanted with an iliac branched endoprosthesis (IBE).

METHODS: We performed a population-based study using the SNDS database, which contains individualized data on refundable healthcare use for almost the entire (>99%) French population. Patients implanted with the GORE® EXCLUDER® Iliac Branch Endoprosthesis from November 1, 2017 to December 31, 2019 were identified by a concomitant combination of implant code and relevant medical procedures codes. Inpatient and outpatient care were retrieved to assess morbidity/mortality via a composite criterion (events: mortality, aortic endovascular reintervention (AER), embolization of any type of endoleak – including type II, branch thrombectomy, bypass).

RESULTS: A total of 361 patients were implanted with the IBE: mean age was 72.4 ± 9.0 years old, 96.1% were males. Median follow-up was 23.1 months (interquartile range: 13.3). Most frequent comorbidities were hypertension (78.1%), coronary artery disease (35.5%), cardiac rhythm disorders (27.1%), smoking (25.8%), peripheral artery disease (24.9%). Mean length of stay for implantation was 5 ± 3.4 days and 47.6% of patients spent 2 ± 1.5 days on average in the intensive care unit. Among 315 patients from the General Insurance Scheme (i.e., with reliable death data), the proportion of patients free from any morbidity/mortality event was estimated at 84.0% (95CI [80.0; 88.0]) and 79.0% [74.0; 84.0] at one year and two years after implantation, respectively. Overall, AER, death and endoleak embolization were the most frequent events: 8.6%, 7.3% and 4.8%, respectively.

CONCLUSIONS: This first real-life study conducted in France since the inception of GORE® EXCLUDER® Iliac Branch Endoprosthesis among refundable devices confirms morbidity/mortality results observed in other countries. Upcoming analysis on longer follow-up will allow the assessment of long-term morbidity/mortality.