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Yu SH, Wu IH. The combination of iliac branch device with parallel stent graft to preserve bilateral internal iliac arteries in a patient with infrarenal abdominal aortic and bilateral common iliac artery aneurysm with short common iliac lengths: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241275848. [PMID: 39205796 PMCID: PMC11350529 DOI: 10.1177/2050313x241275848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
Coexistent aneurysmal involvement of common iliac artery is frequently seen in patients with infrarenal abdominal aortic aneurysm. Bilateral iliac branch devices are an option to preserve bilateral internal iliac arteries in order to decrease the risk of buttock claudication. In Asian population, however, the aortoiliac lengths are commonly not adequate for bilateral iliac branch endoprosthesis. In this technical note, we use a novel hybrid technique to preserve bilateral internal iliac arteries in a patient without adequate aortoiliac length for bilateral iliac branch endoprosthesis. The right internal iliac artery is preserved with iliac branch endoprosthesis. The left internal iliac artery is preserved with cross-over chimney stent grafts which are deployed simultaneously with the parallel grafting of iliac extension from the contralateral gate to the right iliac branch endoprosthesis. Follow-up computed tomography and three-dimensional angiography showed complete aneurysm exclusion with flow preservation to bilateral internal iliac arteries.
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Affiliation(s)
- Sz-Han Yu
- Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Hui Wu
- Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
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2
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Joh JH. Novel Strategies for the Hostile Iliac Artery during Endovascular Aortic Aneurysm Repair. Vasc Specialist Int 2024; 40:8. [PMID: 38475895 DOI: 10.5758/vsi.230119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/29/2024] [Accepted: 02/09/2024] [Indexed: 03/14/2024] Open
Abstract
Successful endovascular aneurysm repair can be achieved with favorable aortic and iliac arterial anatomies. However, patients with challenging iliac anatomy, such as stenotic, calcified, tortuous arteries, or concomitant iliac artery aneurysms, are commonly encountered. Such a hostile iliac anatomy increases the risk of intraprocedural complications and worsens long-term outcomes. This review addresses various technical options for treating patients with a hostile iliac anatomy, including innovative endovascular solutions, physician-modified endografts, and hybrid procedures. These considerations demonstrate the wide scope of therapies that may be offered to patients with an unfavorable iliac anatomy.
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Affiliation(s)
- Jin Hyun Joh
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
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Murai Y, Tamura Y, Tanaka Y, Nakashima K, Miyaji K. Treatment of Complete Displacement of the Bilateral Legs into an Aortic Aneurysm Using an Iliac Branch Device. J Endovasc Ther 2021; 29:143-149. [PMID: 34384277 DOI: 10.1177/15266028211036484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Migration is a major cause of reintervention after endovascular aneurysm repair (EVAR). In patients with common iliac artery (CIA) dilation due to proximal migration of the iliac limb, internal iliac blood flow can be preserved by implanting an iliac branch device (IBD). CASE REPORT In this report, we discuss the case of a patient in whom the bilateral limbs were completely displaced into the aortic aneurysm due to proximal migration of the iliac limb after EVAR. By taking advantage of the characteristics of this migration, we formed a pull-through wire through the native terminal aorta without passing through the flow divider of the stent graft, and the IBD was deployed safely. CONCLUSION The present case indicates that the preservation of at least 1 internal iliac artery is possible in patients with CIA dilation due to proximal migration of the iliac limb. However, the unique features of each case must be considered to determine the appropriate approach.
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Affiliation(s)
- Yuta Murai
- Department of Cardiovascular Surgery, Sagamihara Kyodo Hospital, Sagamihara, Kanagawa, Japan
| | - Yukio Tamura
- Department of Cardiovascular Surgery, Sagamihara Kyodo Hospital, Sagamihara, Kanagawa, Japan
| | - Yuki Tanaka
- Department of Cardiovascular Surgery, Sagamihara Kyodo Hospital, Sagamihara, Kanagawa, Japan
| | - Kouki Nakashima
- Department of Cardiovascular Surgery, Sagamihara Kyodo Hospital, Sagamihara, Kanagawa, Japan
| | - Kagami Miyaji
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
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Chen PL, Hsu HL, Chen IM, Kuo TT, Chen YY, Shih CC. Tailor-made iliac branched device for preserving the internal iliac artery in patients with common iliac artery aneurysm. J Chin Med Assoc 2019; 82:710-713. [PMID: 31335630 DOI: 10.1097/jcma.0000000000000156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Endovascular repair with stent-graft is a treatment option for patient with common iliac artery aneurysm (CIAA). However, the preservation of the internal iliac artery (IIA) is a concern. The commercially available iliac branched device (IBD) requires a common iliac length of at least 5 cm, which is usually too long for Asian people. Here, we report our medium-term results of using tailor-made IBD for patients with short common iliac artery (CIA) with and without abdominal aortic aneurysm (AAA). METHODS A selected iliac limb of the AAA stent-graft was unloaded from the delivery system. A 6-mm fenestration hole was made at the length of the CIA from the proximal end. The edge of the hole was reinforced with the soft and radiopaque tip of a 0.014´´ wire. Then, the iliac limb was reloaded into the introduced sheath as the tailor-made IBD. It was inserted from the selected side of the femoral artery and deployed. The ipsilateral IIA was cannulated through the fenestration hole. Then, a balloon-expandable or self-expandable covered stent with an appropriate size was deployed as the bridging stent-graft. RESULTS Between March 2013 and March 2017, a total of 10 patients received the tailor-made IBDs. One patient died of systemic thromboembolism 2 days after the operation. The bridging stent-grafts remained patent in all patients, except one occluded at 1 year after operation. CONCLUSION A tailor-made IBD is an easy-to-apply, alternative option for preserving the IIA perfusion in short CIAA patients with and without AAA.
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Affiliation(s)
- Po-Lin Chen
- Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Hung-Lung Hsu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Cardiovascular Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC
| | - I-Ming Chen
- Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Tzu-Ting Kuo
- Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yin-Yin Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chun-Che Shih
- Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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Wang L, Liang S, Xu X, Chen B, Jiang J, Shi Z, Tang X, Zhou X, Zhou M, Guo D, Fu W. A Comparative Study of the Efficacy by using Different Stent Grafts in Bell-Bottom Technique for the Treatment of Abdominal Aortic Aneurysm Concomitant with Iliac Artery Aneurysm. Ann Vasc Surg 2018; 52:41-48. [PMID: 29885433 DOI: 10.1016/j.avsg.2018.05.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/20/2018] [Accepted: 05/19/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Bell-bottom technique (BBT) is one method to preserve the internal iliac artery during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) that extends to iliac artery. The data on the efficacy of this technique are still limited. We sought to evaluate the midterm efficacy of BBT by using different stent grafts in the treatment of AAA combined with iliac artery aneurysm (IAA). METHODS From January 2011 to December 2016, AAA patients with IAA using BBT to preserve the internal iliac artery were retrospectively analyzed in our institution. Patients were followed up at 3, 6, and then every 12 months after surgery. The outcomes among 3 types of stent grafts (Zenith, Excluder, and Endurant) were compared. BBT-related end points including type Ib endoleak, IAA sac expansion, distal neck expansion, and rupture during follow-up were compared. Other events including perioperative death, any other types of endoleak, and corresponding management were also documented. RESULTS A total of 125 patients with 141 IAAs were identified. Ninety-eight patients (78.4%) with 113 lesions (80.4%) received a median follow-up time of 38 months. The incidence of type Ib endoleak was 22.9%, 8.3%, 11.9%, and 14.2% (P = 0.19) in Zenith, Excluder, Endurant group, and total patients, respectively. The incidence of IAA sac enlargement was 17.1%, 5.6%, 7.1%, and 9.7% (P = 0.20). The incidence of IAA rupture was 8.6%, 0.0%, 0.0%, and 2.7% (P = 0.03). The incidence of IAA neck enlargement was 34.3%, 13.9%, 16.7%, and 21.2% (P = 0.07). Totally, 14 cases (10.7%) received further treatment for BBT-related issues. CONCLUSIONS Although BBT remains a safe and effective treatment option to preserve internal iliac artery during standard EVAR with acceptable complication rates in Asians, different IAA rupture rates were found among 3 different stent grafts. Our data for the first time revealed that the type of stent grafts has influence on the final clinical outcome. Based on that, iliac extension should be selected appropriately while treating AAA-IAA.
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Affiliation(s)
- Lixin Wang
- Vascular Surgery Department of Zhongshan Hospital, Fudan University, Shanghai, China; Vascular Surgery Institute of Fudan University, Shanghai, China; Vascular Surgery Department of Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China
| | - Shuangchao Liang
- Department of Vascular Surgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
| | - Xin Xu
- Vascular Surgery Department of Zhongshan Hospital, Fudan University, Shanghai, China; Vascular Surgery Institute of Fudan University, Shanghai, China
| | - Bin Chen
- Vascular Surgery Department of Zhongshan Hospital, Fudan University, Shanghai, China; Vascular Surgery Institute of Fudan University, Shanghai, China
| | - Junhao Jiang
- Vascular Surgery Department of Zhongshan Hospital, Fudan University, Shanghai, China; Vascular Surgery Institute of Fudan University, Shanghai, China
| | - Zhenyu Shi
- Vascular Surgery Department of Zhongshan Hospital, Fudan University, Shanghai, China; Vascular Surgery Institute of Fudan University, Shanghai, China
| | - Xiao Tang
- Vascular Surgery Department of Zhongshan Hospital, Fudan University, Shanghai, China; Vascular Surgery Institute of Fudan University, Shanghai, China
| | - Xiushi Zhou
- Vascular Surgery Department of Zhongshan Hospital, Fudan University, Shanghai, China; Vascular Surgery Institute of Fudan University, Shanghai, China
| | - Min Zhou
- Vascular Surgery Department of Zhongshan Hospital, Fudan University, Shanghai, China; Vascular Surgery Institute of Fudan University, Shanghai, China
| | - Daqiao Guo
- Vascular Surgery Department of Zhongshan Hospital, Fudan University, Shanghai, China; Vascular Surgery Institute of Fudan University, Shanghai, China.
| | - Weiguo Fu
- Vascular Surgery Department of Zhongshan Hospital, Fudan University, Shanghai, China; Vascular Surgery Institute of Fudan University, Shanghai, China; Vascular Surgery Department of Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China.
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Giaquinta A, Ardita V, Ferrer C, Beggs CB, Veroux M, Barbante M, Orrico M, Cao P, Veroux P. Isolated Common Iliac Artery Aneurysms Treated Solely With Iliac Branch Stent-Grafts: Midterm Results of a Multicenter Registry. J Endovasc Ther 2018; 25:169-177. [PMID: 30141378 DOI: 10.1177/1526602818754862] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess early and midterm outcomes of iliac branch device (IBD) implantation without an aortic stent-graft for the treatment of isolated common iliac artery aneurysm (CIAA). METHODS From December 2006 to June 2016, 49 isolated CIAAs in 46 patients were treated solely with an IBD at 7 vascular centers. Five patients were lost to follow-up, leaving 41 male patients (mean age 72.5±7.8 years) for analysis. Mean CIAA diameter was 39.1±10.5 mm (range 25-65). Thirty-two patients (2 with bilateral CIAAs) were treated with a Cook Zenith iliac branch device; 9 patients (1 bilateral) received a Gore Excluder iliac branch endoprosthesis. Primary endpoints were technical success, survival, aneurysm exclusion, device patency, and freedom from reintervention at 1 and 5 years. Freedom from major adverse events and aneurysm shrinkage at 1 year were also assessed. RESULTS Thirty-day mortality and the IBD occlusion rate were 2.4% and 2.3%, respectively. At a mean follow-up of 40.2±33.9 months, no patient presented buttock claudication, erectile dysfunction, or bowel or spinal cord ischemia. Three patients died within 6 months after the procedure. Estimates of cumulative survival, device patency, and freedom from reintervention were 90.2%, 95.2%, and 95.7%, respectively, at 1 and 5 years. At 1 year, CIAA shrinkage ≥5 mm was recorded in 21 of 38 survivors. No evidence of endoleak, device migration, or disconnection was found on imaging follow-up. CONCLUSION The use of IBDs without an aortic stent-graft for isolated CIAAs resulted in excellent patency, with low morbidity and mortality. This, in conjunction with no endoleak or migration and a low reintervention rate, supports the use of isolated IBDs as a stable and durable means of endovascular reconstruction in cases with suitable anatomy. Longer follow-up and a larger cohort are needed to validate these results.
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Affiliation(s)
- Alessia Giaquinta
- 1 Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Italy
| | - Vincenzo Ardita
- 1 Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Italy
| | - Ciro Ferrer
- 2 Department of Surgery "Pietro Valdoni," "Sapienza" University, Rome, Italy
| | - Clive B Beggs
- 3 Research Institute for Sport, Physical Activity and Leisure, Carnegie Faculty, Leeds Beckett University, Leeds, UK
| | - Massimiliano Veroux
- 1 Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Italy
| | - Matteo Barbante
- 4 Vascular Surgery Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata," Rome, Italy
| | - Matteo Orrico
- 5 Department of Vascular Surgery, San Filippo Neri Hospital, Rome, Italy
| | - Piergiorgio Cao
- 6 Division of Vascular Surgery, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy
| | - Piefrancesco Veroux
- 1 Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Italy
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Ardita V, Giaquinta A, Veroux M, Sanfiorenzo A, Virgilio C, D’Arrigo G, Veroux P. Endovascular repair of bilateral common iliac artery aneurysms using GORE Excluder iliac branch endoprosthesis without aortobi-iliac stent graft conjunction: A case report. Medicine (Baltimore) 2017; 96:e5977. [PMID: 28207510 PMCID: PMC5319499 DOI: 10.1097/md.0000000000005977] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Bilateral common iliac artery (CIA) aneurysm (CIAA) is a rare entity. In the past decade, different endovascular approaches have been adopted for patients with several comorbidities or unfit for open repair (OR). Recently, the use of iliac branch stent graft has been proposed, resulting in satisfactory patency rates and decrease in morbidity. Currently, according to instruction for use, the iliac branch stent graft is to be used with aortobi-iliac stent graft conjunction. We describe a case of a successful endovascular repair of bilateral CIAAs using the GORE Excluder iliac branch endoprosthesis (IBEs) without aortobi-iliac stent graft conjunction. CASE PRESENTATION An 83-year-old man was admitted with abdominal pain and presence of pulsatile mass in the right and left iliac fossa. Computed tomographic (CT) angiography showed the presence of large bilateral CIAAs (right CIA = 66 mm; left CIA = 38 mm), without concomitant thoracic or abdominal aorta aneurysm. Moreover, CT scan demonstrated the presence of bilateral lower accessory renal artery close to the aortic bifurcation. Due to the high operative risk, the patient was scheduled for endovascular repair with bilateral IBEs, without the aortobi-iliac stent graft conjunction to avoid the renal ischemia as a consequence of renal arteries covering. The procedure was completed without complications and duplex ultrasound demonstrated the complete exclusion of both aneurysms without any type of endoleaks at 1 month of follow-up. CONCLUSIONS GORE IBEs without aortobi-iliac stent graft conjunction seem to be a feasible and effective procedure for the treatment of isolated CIAAs in patients with highly selected anatomical conditions.
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Affiliation(s)
- Vincenzo Ardita
- Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Via Santa Sofia, Catania
- Vascular Surgery Unit, Guzzardi Hospital of Vittoria, Via Papa Giovanni XXIII, Vittoria
| | - Alessia Giaquinta
- Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Via Santa Sofia, Catania
| | - Massimiliano Veroux
- Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Via Santa Sofia, Catania
- Department of Medical and Surgical Sciences and Advanced Technologies, University Hospital of Catania, Via Santa Sofia, Catania
| | - Angelo Sanfiorenzo
- Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Via Santa Sofia, Catania
| | - Carla Virgilio
- Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Via Santa Sofia, Catania
| | - Giuseppe D’Arrigo
- Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Via Santa Sofia, Catania
| | - Pierfrancesco Veroux
- Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Via Santa Sofia, Catania
- Department of Surgical Specialties, University Hospital of Catania, Via Santa Sofia, Catania, Italy
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Canyigit M, Hidiroglu M, Uguz E, Cetin H. Iliorenal periscope graft to maintain blood flow to accessory renal artery. Diagn Interv Radiol 2016; 21:334-7. [PMID: 25959546 DOI: 10.5152/dir.2014.14358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Parallel endografts such as "chimney" and "periscope" are being increasingly used to maintain blood flow to visceral and supra-aortic branches in patients with different aortic disorders. We present a new technique, "iliorenal periscope graft", in a patient with abdominal aortic aneurysm undergoing endovascular aortic repair. In this case, left accessory renal artery flows were provided by an iliorenal periscope graft that extends from the left accessory renal artery to the right common iliac artery in a retrograde fashion.
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Affiliation(s)
- Murat Canyigit
- Department of Radiology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
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Kim MH, Park KM, Jeon YS, Cho SG, Hong KC, Shin WY, Choe YM, Shin SH, Kim KR. One Year Experience of Iliac Bifurcated Device for Aortoiliac Aneurysm in a Korean Single Center. Vasc Specialist Int 2016; 31:130-4. [PMID: 26719840 PMCID: PMC4694185 DOI: 10.5758/vsi.2015.31.4.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/01/2015] [Accepted: 09/15/2015] [Indexed: 11/20/2022] Open
Abstract
One of the predominant methods for preserving the internal iliac artery (IIA) in aortoiliac aneurysms is to use an iliac bifurcated device (IBD). However, there are a few limitations to the use of IBD in Korea. Our study aims to present the technical aspects of these devices, and to provide a mid-term analysis of IBD. Since 2013, 4 IBDs were used in 4 patients, with a mean follow-up of 14 months (range, 6-22 months). A 100% technical success rate was achieved without mortality and morbidity in our cases. The mean procedural time was 176 min (range, 145-240 min), and the mean contrast dose used was 184 mL (range, 135-220 mL). Type I or III endoleaks and postoperative expansion of the aneurysms weren't observed. Our cases demonstrates that IBD is a relatively safe repair method of aortoiliac aneurysms with preservation of the IIAs. However, a longer follow-up is needed to review the midterm results.
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Affiliation(s)
- Moon Hwan Kim
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Keun-Myoung Park
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Yong Sun Jeon
- Department of Radiology, Inha University College of Medicine, Incheon, Korea
| | - Soon Gu Cho
- Department of Radiology, Inha University College of Medicine, Incheon, Korea
| | - Kee Chun Hong
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Woo Young Shin
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Yun-Mee Choe
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Seok-Hwan Shin
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Kyung Rae Kim
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
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Kim JT, Jeon YS, Lim HK, Kim YS, Yoon YH, Baek WK. Endovascular Treatment of Isolated Bilateral Common Iliac Artery Aneurysms Using Iliac Branched Stent Graft. Vasc Specialist Int 2015. [PMID: 26217623 PMCID: PMC4480293 DOI: 10.5758/vsi.2014.30.3.87] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Endovascular treatment of isolated bilateral common iliac artery aneurysm (CIAA) requires salvage of at least one internal iliac artery to prevent complications such as ischemic buttock claudication. We treated a case of bilateral CIAAs using an internal iliac branched stent graft. We report a case of a 58-year-old man who presented with bilateral CIAAs. The left internal iliac artery was occluded with coil embolization. The right internal iliac artery was saved by using a branched stent graft. The aneurysms were excluded with conventional endovascular aneurysm repair. Completion angiography showed technical success. Follow up computed tomography angiogram at three months showed complete exclusion of bilateral CIAAs, no endoleaks, and patent right internal iliac artery. There was no pelvic ischemic complication. We treated successfully a case of isolated bilateral CIAAs using an iliac branched stent graft.
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Affiliation(s)
- Joung Taek Kim
- Departments of Thoracic and Cardiovascular Surgery, Inha University Hospital, Incheon, Korea
| | | | - Hyun Kyung Lim
- Anesthesiology and Pain Medicine, Inha University Hospital, Incheon, Korea
| | - Young Sam Kim
- Departments of Thoracic and Cardiovascular Surgery, Inha University Hospital, Incheon, Korea
| | - Yong Han Yoon
- Departments of Thoracic and Cardiovascular Surgery, Inha University Hospital, Incheon, Korea
| | - Wan Ki Baek
- Departments of Thoracic and Cardiovascular Surgery, Inha University Hospital, Incheon, Korea
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Wu IH, Chou HW, Chang CH, Lin CF, Chi NH, Wang SS. Crossover chimney technique to preserve the internal iliac artery during endovascular repair of iliac or aortoiliac aneurysms: midterm results. J Endovasc Ther 2015; 22:388-95. [PMID: 25878024 DOI: 10.1177/1526602815581596] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To report our midterm results of the crossover chimney technique to preserve the internal iliac artery (IIA) in patients with aortoiliac aneurysms (AIA) and isolated common iliac artery aneurysms (CIAA). METHODS Between May 2012 and January 2014, 14 consecutive patients (mean age 77.3 years; all men) with 17 AIA, isolated CIAAs, or abdominal aortic aneurysms with short CIAs underwent elective endovascular aneurysm repair (EVAR) with the crossover chimney technique to preserve the IIA. Follow-up assessment, including computed tomographic angiography or duplex ultrasound, was performed at 1, 6, and 12 months and annually thereafter. RESULTS Technical success, defined as successful preservation of IIA without intraoperative type I or III endoleak, was 100%. Over a mean 14.3 months (range 6-21), primary patency was 92.8%. There was no early or late procedure-related mortality. Among the 17 iliac aneurysms excluded, the sac diameter significantly (at least 5 mm) decreased in 3, decreased <5 mm in 10, and did not change in 4. CONCLUSION The crossover chimney technique is a simple and safe alternative for IIA endovascular revascularization with high technical success and acceptable midterm patency.
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Affiliation(s)
- I-Hui Wu
- Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Heng-Wen Chou
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Yun-Lin Branch, Yun Lin, Taiwan
| | - Chin-Hao Chang
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Feng Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Nai-Hsin Chi
- Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shoei-Shen Wang
- Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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12
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Lepidi S, Piazza M, Scrivere P, Menegolo M, Antonello M, Grego F, Frigatti P. Parallel Endografts in the Treatment of Distal Aortic and Common Iliac Aneurysms. Eur J Vasc Endovasc Surg 2014; 48:29-37. [DOI: 10.1016/j.ejvs.2014.03.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 03/20/2014] [Indexed: 10/25/2022]
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13
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Chaudhuri A. Periscopes, Snorkels and Chimneys: No Smoke Without Fire? Eur J Vasc Endovasc Surg 2014; 47:218-20. [DOI: 10.1016/j.ejvs.2013.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 11/07/2013] [Indexed: 11/28/2022]
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