Internal iliac artery occlusion using a stent-graft tunnel during endovascular aneurysm repair: a new alternative to coil embolization.
OBJECTIVE
To report a new endovascular technique for internal iliac artery (IIA) occlusion during stent-graft treatment in patients with aortoiliac aneurysm.


METHODS
Stent-grafts measuring 20 to 28 mm in diameter and 37.5 mm long were deployed at the iliac bifurcation to occlude the IIA at its origin. Subsequent deployment of an aortic bifurcation endograft with ipsilateral extension into the external iliac artery was through this iliac stent-graft tunnel. This approach has been used in 5 patients with abdominal aortic aneurysm and common iliac artery aneurysm (n=4) or isolated iliac artery aneurysm. Proximal IIA occlusion was achieved in all cases with no distal type I endoleak. IIA patency on the side opposite to the tunnel procedure was preserved in each case. No patient described new onset of pelvic ischemic symptoms. Over a mean 10-month follow-up (range 1-12), there was no secondary procedure required for type I endoleak. Three patients had a CIA aneurysm diameter change of -1, -4, and 0 mm at 1 year.


CONCLUSIONS
This new method for IIA occlusion at its origin without coil embolization may prove to be a useful adjunct to endovascular aortoiliac aneurysm repair. The technique is simple, rapid, and may minimize the risk of pelvic ischemia.
Rajasinghe
Hiranya A
HA
Jobst Vascular Center, Toledo, Ohio 43606, USA.
Pigott
John P
JP
Kritpracha
Boonprasit
B
Corbey
Mary Jo
MJ
Beebe
Hugh G
HG
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000628:therapy*; D001027:Aortography; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D021721:Balloon Occlusion / Q000295:instrumentation / Q000379:methods*; D004621:Embolization, Therapeutic / Q000379:methods; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging*; D008297:Male; D018570:Risk Assessment; D012494:Sampling Studies; D015607:Stents; D016896:Treatment Outcome