Aorto uni-iliac modification of a bifurcated stent graft for endovascular aneurysm repair: Expanding the versatility of a modular device.
As endografting technology advances, anatomical constraints limiting access and deployment have become less of a burden. While unsuitable candidates for endografting exist, these patients are becoming less frequent. To broaden the applicability of endovascular abdominal aortic aneurysm repair (EVAR), we have modified the bifurcated AneuRx device into a unilimb modular prosthesis, by placing an aortic extender cuff across the flow divider, thus excluding its contralateral limb. This technique was used with success in 3 groups of patients: with occlusion of 1 iliac artery, with a nontraversable iliac stenosis, or with a small calcific aortic bifurcation. In these patients, anatomy can make it difficult, if not impossible, to place a bifurcated stent graft. Whether as a planned preoperative procedure or as a ;;bail-out'' maneuver, this procedure has been successful in avoiding open surgical conversion.
Sampaio
Sergio M M
SM
Division of Vascular Surgery, Mayo Clinic, Rochester, MN, USA.
Panneton
Jean M
JM
Brink
Jeromy S
JS
Andrews
James C
JC
McKusick
Michael C
MC
Gloviczki
Peter
P
D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000473:pathology / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000473:pathology / Q000601:surgery; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D018579:Patient Selection; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation*