Retrograde endovascular hypogastric artery preservation (REHAP) and aortouniiliac (AUI) endografting in the management of complex aortoiliac aneurysms.
The preservation of internal iliac artery (IIA) flow during endovascular repair of abdominal aortic aneurysms (er-AAA) remains a controversial area. Ectasia and aneurysmal disease of the iliac arteries represent a formidable challenge to the endovascular surgeon, particularly when aortic neck length and diameter are suitable for er-AAA. We describe a procedure to maintain arterial perfusion to the pelvis during er-AAA called retrograde endovascular hypogastric artery preservation (REHAP). This technique is particularly useful in the presence of common iliac artery (CIA) and internal iliac artery (IIA) aneurysms when pelvic perfusion to one IIA needs to be maintained. A Wallgraft is first placed from the IIA to the ipsilateral EIA followed by er-AAA using an aortouniiliac graft (AUI) and a femorofemoral bypass graft (BPG). This procedure represents one alternative to maintaining pelvic perfusion using standard endovascular and surgical techniques.
Ayerdi
Juan
J
Section of Peripheral Vascular Surgery, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL 62794-9638, USA. rmclaferty@siumed.edu
McLafferty
Robert B
RB
Solis
Maurice M
MM
Teruya
Theodore
T
Danetz
Jeffrey S
JS
Parra
Jose R
JR
Gruneiro
Laura A
LA
Ramsey
Don E
DE
Hodgson
Kim J
KJ
D001014:Aortic Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007511:Ischemia / Q000517:prevention & control*; D010388:Pelvis / Q000098:blood supply*