title: Surgeon custom-made iliac branch device to salvage hypogastric artery during endovascular aneurysm repair.
abstract: Endovascular salvage of the hypogastric artery using iliac branch device (IBD) during endovascular aortic aneurysm repair (EVAR), offers less invasive alternative solution to surgery to prevent pelvic ischemia. We have performed the first Korean surgeon custom-made IBD for this purpose to overcome the limitation of unavailability of the devices in Korea. Four patients with abdominal aortic aneurysm with bilateral common iliac artery aneurysm (CIAA) were treated using custom-made IBDs from October 2013 to December 2013. IBD was created in back table before EVAR operation using TFLE Zenith iliac limb stent graft (Cook Inc.). Three V12 (Atrium, Inc.) one Viabahn (Gore, Inc.) were used for bridging between IBD and target hypogastric artery. With this modification of IBD procedure, exteriorize the guide wire without snare device is possible which offers another benefit in terms of reducing medical costs comparing to commercial IBD. All operations were successful without any device related complications or postoperative endoleaks. During the mean follow up of 3 months, all IBD were patent without clinical complications. Surgeon custom made IBD is feasible and useful to preserve pelvic perfusion especially in the situation of limited commercial IBD availability in many countries. Long-term follow-up is needed to evaluate stent graft patency and IBD-related complications.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Daegu Catholic University College of Medicine, Daegu, Korea.
authors.forename: Young Eun
authors.identifier: 0000-0002-5211-9500
authors.initials: YE
authors.lastname: Park
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Daegu Catholic University College of Medicine, Daegu, Korea.
authors.forename: Jae Hoon
authors.identifier: 0000-0002-0906-5236
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Surgery, Yeungnam University, College of Medicine, Daegu, Korea.
authors.forename: Woo-Sung
authors.identifier: 0000-0001-8956-8310
authors.initials: WS
authors.lastname: Yun
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Daegu Catholic University College of Medicine, Daegu, Korea.
authors.forename: Ki Hyuk
authors.identifier: 0000-0001-9679-2820
authors.initials: KH
authors.lastname: Park
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D057510:Endovascular Procedures / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000601:surgery*; D007083:Iliac Artery / Q000601:surgery*; D008297:Male; D016879:Salvage Therapy / Q000295:instrumentation* / Q000379:methods; D015607:Stents
keywords: Custom-Made; Endovascular Aneurysm Repair; Iliac Branch Device