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Using a surgeon-modified iliac branch device to preserve the internal iliac artery during endovascular aneurysm repair: single-center experiences and early results.

Wu WW, Lin C, Liu B, Liu CW - Chin. Med. J. (2015)

Bottom Line: Technical successes were obtained in all patients.All grafts remained patent without any sign of endoleaks.There were no aneurysm ruptures, deaths, or other complications related to pelvic flow.

View Article: PubMed Central - PubMed

Affiliation: Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China.

ABSTRACT

Background: To evaluate the feasibility of a new surgeon-modified iliac branch device (IBD) technique to maintain pelvic perfusion in the management of common iliac artery (CIA) aneurysm during endovascular aneurysm repair (EVAR).

Methods: From January 2011 to December 2013, a new surgeon-modified IBD technique was performed in department of vascular surgery of Peking Union Medical College Hospital in five patients treated for CIA aneurysm with or without abdominal aortic aneurysm. A stent-graft limb was initially deployed in vitro, anastomosed with vascular graft, creating a modified IBD reloaded into a larger sheath, with or without a guidewire preloaded into the side branch. The reloaded IBD was then placed in the iliac artery, with a covered stent bridging internal iliac artery and the branch. Finally, a bifurcated stent-graft was deployed, and a limb device was used to connect the main body and IBD.

Results: Technical successes were obtained in all patients. The mean follow-up length was 24 months (range: 6-38 months). All grafts remained patent without any sign of endoleaks. There were no aneurysm ruptures, deaths, or other complications related to pelvic flow.

Conclusions: Using the surgeon-modified IBD to preserve pelvic flow is a feasible endovascular technique and an appealing solution for personalized treatment of CIA aneurysm during EVAR.

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Related in: MedlinePlus

Follow-up of an IBD procedure. (a) Preoperative CTA displayed large iliac aneurysms and angulated right IIA; (b) Postoperative CTA revealed preserved right IIA with its branches, and patent grafts with no endoleak after 24-month follow-up. CTA: Computed tomographic angiography; IBD: Iliac branch device; IIA: Internal iliac artery.
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Figure 5: Follow-up of an IBD procedure. (a) Preoperative CTA displayed large iliac aneurysms and angulated right IIA; (b) Postoperative CTA revealed preserved right IIA with its branches, and patent grafts with no endoleak after 24-month follow-up. CTA: Computed tomographic angiography; IBD: Iliac branch device; IIA: Internal iliac artery.

Mentions: Technical successes were obtained in all of the five patients with aneurysms repaired, and target IIAs reconstructed. Completing angiography showed a mild Type II endoleak in one patient, which disappeared 3 months later. The mean follow-up length was 24 months (range: 6–38 months). All grafts remained patent without any sign of migration, fracture or endoleaks, and IIA flow was preserved [Figure 5]. There were no aneurysm ruptures, deaths, or other complications related to pelvic flow. Aneurysm shrinkage of >5 mm was seen in all patients in computed tomography (CT) scan. No aneurysm enlargement was observed in any patient.


Using a surgeon-modified iliac branch device to preserve the internal iliac artery during endovascular aneurysm repair: single-center experiences and early results.

Wu WW, Lin C, Liu B, Liu CW - Chin. Med. J. (2015)

Follow-up of an IBD procedure. (a) Preoperative CTA displayed large iliac aneurysms and angulated right IIA; (b) Postoperative CTA revealed preserved right IIA with its branches, and patent grafts with no endoleak after 24-month follow-up. CTA: Computed tomographic angiography; IBD: Iliac branch device; IIA: Internal iliac artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834782&req=5

Figure 5: Follow-up of an IBD procedure. (a) Preoperative CTA displayed large iliac aneurysms and angulated right IIA; (b) Postoperative CTA revealed preserved right IIA with its branches, and patent grafts with no endoleak after 24-month follow-up. CTA: Computed tomographic angiography; IBD: Iliac branch device; IIA: Internal iliac artery.
Mentions: Technical successes were obtained in all of the five patients with aneurysms repaired, and target IIAs reconstructed. Completing angiography showed a mild Type II endoleak in one patient, which disappeared 3 months later. The mean follow-up length was 24 months (range: 6–38 months). All grafts remained patent without any sign of migration, fracture or endoleaks, and IIA flow was preserved [Figure 5]. There were no aneurysm ruptures, deaths, or other complications related to pelvic flow. Aneurysm shrinkage of >5 mm was seen in all patients in computed tomography (CT) scan. No aneurysm enlargement was observed in any patient.

Bottom Line: Technical successes were obtained in all patients.All grafts remained patent without any sign of endoleaks.There were no aneurysm ruptures, deaths, or other complications related to pelvic flow.

View Article: PubMed Central - PubMed

Affiliation: Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China.

ABSTRACT

Background: To evaluate the feasibility of a new surgeon-modified iliac branch device (IBD) technique to maintain pelvic perfusion in the management of common iliac artery (CIA) aneurysm during endovascular aneurysm repair (EVAR).

Methods: From January 2011 to December 2013, a new surgeon-modified IBD technique was performed in department of vascular surgery of Peking Union Medical College Hospital in five patients treated for CIA aneurysm with or without abdominal aortic aneurysm. A stent-graft limb was initially deployed in vitro, anastomosed with vascular graft, creating a modified IBD reloaded into a larger sheath, with or without a guidewire preloaded into the side branch. The reloaded IBD was then placed in the iliac artery, with a covered stent bridging internal iliac artery and the branch. Finally, a bifurcated stent-graft was deployed, and a limb device was used to connect the main body and IBD.

Results: Technical successes were obtained in all patients. The mean follow-up length was 24 months (range: 6-38 months). All grafts remained patent without any sign of endoleaks. There were no aneurysm ruptures, deaths, or other complications related to pelvic flow.

Conclusions: Using the surgeon-modified IBD to preserve pelvic flow is a feasible endovascular technique and an appealing solution for personalized treatment of CIA aneurysm during EVAR.

Show MeSH
Related in: MedlinePlus