title: Antegrade, covered, self-expanding stent as an iliac extension in a bifurcated endograft: a feasible technical maneuver for challenging aortoiliac aneurysmal anatomy.
abstract: BACKGROUND
  Aneurysmal and occlusive aortoiliac disease can make the process of introducing large delivery catheters for endovascular repair challenging. We describe the case of a patient who could be treated by a bifurcated stent-graft despite having a unilateral external iliac occlusion.
  
  
  RESULTS
  From a brachial access, a covered self-expanding stent was deployed antegradely through the distal gate of the stent-graft into the common iliac artery. This technical choice helped to overcome the problem of an external iliac occlusion, so as to maintain an antegrade flow into the internal iliac and avoid the need for an interfemoral bypass.
  
  
  CONCLUSIONS
  Auto-expandable covered stent-graft with a thinner shaft can be used through a brachial access as an iliac extension of a bifurcated aortic endograft. However, a longer follow-up duration and more cases are necessary to warrant the safety and the durability of such an "off-label" endovascular material assemblage.
authors.affiliation: Service de Chirurgie Vasculaire, Hôpital Européen Georges Pompidou, Université René Descartes, Paris, France. jean-marc.alsac@egp.aphp.fr
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Alsac
authors.forename: Pierre
authors.initials: P
authors.lastname: Julia
authors.forename: Jean-Noël
authors.initials: JN
authors.lastname: Fabiani
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D001916:Brachial Artery / Q000000981:diagnostic imaging; D057510:Endovascular Procedures / Q000295:instrumentation*; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome