Emergent conversion of the Ovation Stent Graft System to aortouniiliac modification via occlusion of a unilateral internal iliac artery with a stentgraft as a bailout solution.
OBJECTIVE
To present a case of inadvertent collapse of the contralateral limb gate caused by misorientation during the deployment of the Ovation Abdominal Stent Graft System in a narrow aortic lumen and the bailout conversion to aortouniiliac modification, using a covered stent to exclude the orifice of the internal iliac artery (IIA).
Despite the repeated efforts from the femoral and brachial site, the collapsed/occluded contralateral limb gate could not be catheterized. In order to exclude successfully the orifice of the IIA, an oversized stentgraft was placed immediately at the common-to-external iliac artery (CIA-EIA) transition followed by peripheral ligation of the latter. The procedure was completed with crossover femorofemoral bypass.


CONCLUSIONS
Occlusion the IIA orifice with an oversized stentgraft in the CIA-EIA transition can be considered as a safe, simple, fast, and efficient bailout maneuver, followed by EIA ligation and crossover bypass.
Department of Vascular Surgery, "Democritus" University of Thrace, University Hospital of Alexandroupolis, Dragana, Greece efstratiosgeorg@gmail.com.
Efstratios
E
Georgakarakos
Department of Vascular Surgery, "Democritus" University of Thrace, University Hospital of Alexandroupolis, Dragana, Greece.
Nikolaos
N
Schoretsanitis
Interventional Radiology Unit, "Democritus" University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
Vasileios D
VD
Souftas
Department of Vascular Surgery, "Democritus" University of Thrace, University Hospital of Alexandroupolis, Dragana, Greece.
Chris
C
Argyriou
2nd Department of Surgery, "Democritus" University of Thrace, Medical School, University Hospital of Alexandroupolis, Dragana, Greece.
Erchan
E
Moustafa
Department of Vascular Surgery, "Democritus" University of Thrace, University Hospital of Alexandroupolis, Dragana, Greece.
George S
GS
Georgiadis
Department of Vascular Surgery, "Democritus" University of Thrace, University Hospital of Alexandroupolis, Dragana, Greece.
Miltos K
MK
Lazarides
D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D004630:Emergencies; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008026:Ligation; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Abdominal aortic aneurysm; aortouniliac endograft; endovascular aneurysm repair; limb occlusion; ovation; stentgraft