title: Internal iliac artery occlusion using a stent-graft tunnel during endovascular aneurysm repair: a new alternative to coil embolization.
abstract: 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.
authors.affiliation: Jobst Vascular Center, Toledo, Ohio 43606, USA.
authors.forename: Hiranya A
authors.initials: HA
authors.lastname: Rajasinghe
authors.forename: John P
authors.initials: JP
authors.lastname: Pigott
authors.forename: Boonprasit
authors.initials: B
authors.lastname: Kritpracha
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Corbey
authors.forename: Hugh G
authors.initials: HG
authors.lastname: Beebe
mesh_terms: 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