title: Technical Notes for Treatment of a Pluri-Relapsing Iliac and Femoral Pseudoaneurysm.
abstract: BACKGROUND
  To describe a technique that connects an Anaconda stent graft (Vascutek, Terumo, Inchinnan, Scotland) to a target artery in a hybrid method.
  
  
  METHODS
  The patient was a 65-year-old man with a huge pluri-relapsing iliac and femoral pseudoaneurysm of a previous aortobifemoral bypass. An Anaconda stent graft was used to repair the lesion. After partial dissection of the femoral bifurcation, the Anaconda stent graft was partially introduced via a direct puncture in the anterior wall of the femoral artery over a guidewire. The end of the stent graft outside that artery was cut and adjusted to the exact length to be sutured in an end-to-end fashion to the profunda femoral artery. The proximal sutureless telescoping anastomosis avoided a challenging and risky iliac surgical access. The distal surgical anastomosis guaranteed a stable suture in such a dynamic region.
  
  
  CONCLUSIONS
  The hybrid technique using the Anaconda stent graft herein described is a safe alternative for challenging iliofemoral aneurysmatic disease treatment. Longer follow-up and more patients are needed before this technique could be recommended for use.
authors.affiliation: Vascular and Endovascular Surgery Unit, Department of Surgery, "San Giovanni di Dio" Hospital, Florence, Italy. Electronic address: e.chisci@gmail.com.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Chisci
authors.affiliation: Vascular and Endovascular Surgery Unit, Department of Surgery, "San Giovanni di Dio" Hospital, Florence, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Barbanti
authors.affiliation: Vascular and Endovascular Surgery Unit, Department of Surgery, "San Giovanni di Dio" Hospital, Florence, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Romano
authors.affiliation: Vascular and Endovascular Surgery Unit, Department of Surgery, "San Giovanni di Dio" Hospital, Florence, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Troisi
authors.affiliation: Vascular and Endovascular Surgery Unit, Department of Surgery, "San Giovanni di Dio" Hospital, Florence, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Ercolini
authors.affiliation: Vascular and Endovascular Surgery Unit, Department of Surgery, "San Giovanni di Dio" Hospital, Florence, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Michelagnoli
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000295:instrumentation; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011474:Prosthesis Design; D012008:Recurrence; D015607:Stents; D013536:Suture Techniques; D016896:Treatment Outcome; D014654:Vascular Patency