Endovascular repair of aortoiliac aneurysm with a hybrid technique to preserve pelvic perfusion.

Abstract

Endovascular aneurysm repair (EVAR) has been proven to be an effective and safe technique for abdominal or iliac artery aneurysm. However, for aneurysms extending to both iliac bifurcations, routine EVAR will occlude both internal iliac arteries (IIAs), which may increase the risk for pelvic ischemia. New endovascular techniques have been developed to preserve the pelvic perfusion in EVAR for such situation. This article reports an endovascular repair of an aortoiliac aneurysm with an external iliac artery (EIA) to the IIA endograft to preserve the pelvic perfusion. First, an endograft was advanced into the left IIA under the help of an inflated aortic balloon. Coils were deployed to embolize the distal type-1 endoleak from the tunnel around the endograft. and an aortouniiliac endograft and an iliac extension were deployed below the renal arteries extending to the right EIA. Finally, a right-to-left femoro-femoral artery bypass was constructed. Angiography at completion and computed tomography after 6 months demonstrated patency of all grafts and complete exclusion of the aneurysm without any endoleak. Endovascular repair with an EIA-to-IIA endograft to preserve the pelvic inflow is a feasible and effective technique for aortoiliac aneurysms. Coil embolization might be an option to repair the distal type of endoleak. The balloon assisted U-turn technique may help advance the endovascular device over a sharp-angled vessel bifurcation.

• Authors: Wei-Wei Wu, Xue-Ying Jiang, Bao Liu, Yu Chen, Chang-Wei Liu
• Journal: Chinese medical journal (Chin Med J (Engl)) Vol. 124 Issue 23 Pg. 4105-8 (Dec 2011) ISSN: 2542-5641 [Electronic] China
• PMID: 22340353 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Angiography
• Aortic Aneurysm, Abdominal (diagnostic imaging, surgery)
• Humans
• Iliac Aneurysm (diagnostic imaging, surgery)
• Male
• Pelvis
• Vascular Surgical Procedures