Ann Surg Treat Res.  2015 Aug;89(2):107-110. 10.4174/astr.2015.89.2.107.

Endovascular aortic aneurysm repair using a bifurcated stent graft in a patient with femoro-femoral bypass

• Kang SH
• Bae JM
• Yun WS

• KMID: 2166980
• DOI: http://doi.org/10.4174/astr.2015.89.2.107

Abstract

A challenging iliac anatomy remains a major obstacle to successful endovascular aortic aneurysm repair. The authors experienced an abdominal aortic aneurysm with bilateral common iliac artery aneurysms in a patient that had undergone femoro-femoral bypass due to left external iliac artery (EIA) occlusion. To treat this patient in a totally endovascular manner, a bifurcated stent graft was used. One iliac limb was deployed in the right internal iliac artery (IIA) and the other in the right EIA; the left IIA was embolized with coils. Here, the authors describe the procedure used and provide technical tips.

Keyword

Abdominal aortic aneurysm; Endovascular aneurysm repair

MeSH Terms

Aneurysm
Aortic Aneurysm*
Aortic Aneurysm, Abdominal
Blood Vessel Prosthesis*
Extremities
Humans
Iliac Artery

Figure

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  Fig. 1 Preoperative computed tomography arteriography. Axial images (A, B) and volume rendering image (C).

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  Fig. 2 Preoperative anatomical measurements (A) and endovascular aortic aneurysm repair planning (B). Unit: mm.

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  Fig. 3 Procedural details. (A) The left right internal iliac artery (IIA) was embolized with coils through the left axillary artery. (B) The main body stent graft (Zenith, 24-82 mm) was deployed after aortography. (C) The contralateral gate of the main body was cannulated via the main body sheath. (D) A contralateral bridge iliac limb (Zenith, 8-54 mm) was deployed. (E) The contralateral iliac limb was extended to the right IIA using a 10 × 100-mm Viabahn stent graft. (F) Finally, the ipsilateral iliac limb (Zenith, 12-90 mm) was deployed to the right external iliac artery.

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  Fig. 4 Follow-up computed tomography arteriography 6 months after endovascular aortic aneurysm repair. Axial images (A, B) and volume rendering image (C).

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