title: Crossover chimney technique to preserve the internal iliac artery in abdominal aortic aneurysm with common iliac artery aneurysms.
abstract: OBJECTIVE
  To report a new technique to preserve the internal iliac artery (IIA) in cases of aortoiliac aneurysms.
  
  
  METHODS
  Under bilateral common femoral artery (CFA) exposure, a crossover sheath was inserted from the contralateral CFA to the ipsilateral IIA involved in the common iliac artery (CIA) aneurysm. A Viabahn stent-graft was positioned 2 cm inside the IIA. The main body abdominal stent-graft was inserted through the ipsilateral CFA with distal sealing in the external iliac artery (EIA). The gate was cannulated, and the limb extension was positioned in the contralateral CIA near the IIA orifice. After the first Viabahn deployment, a second device was deployed with a minimum 1-cm overlap inside the first Viabahn and 2 mm distal to the limb extension. For bilateral CIA aneurysms, the Viabahn and extension limb were landed in the EIA with IIA embolization. In the past year, this technique has been used in 5 patients with success. There was no acute branch occlusion or type I endoleak from the IIA or chimney graft gutters on imaging studies up to 6 months.
  
  
  CONCLUSIONS
  This technique is easy to use and avoids the brachial access of the sandwich technique and the additional cost of an iliac branch device.
authors.affiliation: Department of Surgery, Cardiovascular Division, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: I-Hui
authors.initials: IH
authors.lastname: Wu
authors.forename: Chih-Yang
authors.initials: CY
authors.lastname: Chan
authors.forename: Yih-Sharng
authors.initials: YS
authors.lastname: Chen
authors.forename: Shu-Chien
authors.initials: SC
authors.lastname: Huang
authors.forename: Shoei-Shen
authors.initials: SS
authors.lastname: Wang
authors.forename: Nai-Hsin
authors.initials: NH
authors.lastname: Chi
mesh_terms: D000369:Aged, 80 and over; D000783:Aneurysm / Q000150:complications* / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008297:Male; D015607:Stents