title: From aortouniiliac bifurcated to aortobisiliac trifurcated endograft for hypogastric artery preservation during EVAR.
abstract: An 81-year-old man presented with rapid enlargement of a 2-year known abdominal aortic and common iliac aneurysms. A hybrid approach to preserve both hypogastric arteries (HAs) was planned: a bifurcated endograft for the right aortoiliac axis, right femoral-to-left femoral artery bypass, and left external-to-internal iliac artery stent graft placement. Urethral stenosis requiring an epicystostomy rendered this approach not feasible. After left HA embolization, a bifurcated endograft was deployed for the abdominal aortic aneurysm exclusion. The endograft right limb was extended using a second bifurcated endograft for the ipsilateral aortoiliac axis. Surgical femoral accesses were used for the 2 bifurcated endografts and left HA embolization. Through the left brachial access, 2 stent grafts were used to preserve the right hypogastric artery revascularization. The 5-year follow-up computed tomography scan demonstrated complete aneurysm exclusion and HA patency.
authors: Vascular Surgery Unit, Department of Surgery, "San Francesco" Hospital, Nuoro, Italy. Electronic address: kasemiholta@libero.it.
authors: Holta
authors: H
authors: Kasemi
authors: Vascular Surgery Unit, Department of Surgery, "San Francesco" Hospital, Nuoro, Italy.
authors: Mario
authors: M
authors: Marino
authors: Vascular Surgery Unit, Department of Surgery, "San Francesco" Hospital, Nuoro, Italy.
authors: Costantino Luca
authors: CL
authors: Di Angelo
authors: Vascular Surgery Unit, Department of Surgery, "San Francesco" Hospital, Nuoro, Italy.
authors: Patrizia
authors: P
authors: Pileri
authors: Vascular Surgery Unit, "C. Panico" Hospital, Tricase, Italy.
authors: Carlo Patrizio
authors: CP
authors: Dionisi
authors: Vascular Surgery Unit, Department of Surgery, "San Francesco" Hospital, Nuoro, Italy.
authors: Gian Franco
authors: GF
authors: Fadda
mesh_terms: D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003287:Contrast Media; D003952:Diagnostic Imaging; D006801:Humans; D017543:Iliac Aneurysm / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D013270:Stomach / Q000098:blood supply*
chemical_list: D003287:Contrast Media