Document Detail


Preservation of Hypogastric Artery Blood Flow During Endovascular Aneurysm Repair of an Abdominal Aortic Aneurysm With Bilateral Common and Internal Iliac Artery Involvement: Utilization of Off-the-Shelf Stent-Graft Components.
MedLine Citation:
PMID:  22176882     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
A 72-year-old male presented with a 7.4-cm abdominal aortic aneurysm with bilateral common and internal iliac involvement. To maintain pelvic perfusion, preservation of the patient's left hypogastric artery (HA) was pursued. Two weeks after right HA embolization, endovascular repair of the patient's aneurysms was performed using a branched endograft approach. A 22-mm main body bifurcated endograft was unsheathed and the proximal covered stent was removed. The contralateral gate was preloaded with a wire and catheter. The device was resheathed and placed in the left common iliac artery. The preloaded wire in the contralateral gate was snared from the right side, establishing through-and-through femoral access. A contralateral femoral sheath was advanced up and over the aortic bifurcation from the right side into the contralateral gate of the bifurcated endograft. The repair was bridged to the left HA using a balloon-expandable stent-graft, followed by standard endovascular abdominal aortic aneurysm repair. Completion angiography demonstrated exclusion of patient's aneurysms, without evidence of endoleak, and maintenance of pelvic blood flow through the left HA. The patient recovered without complication and was discharged home on postoperative day 4. This technique illustrates the technical feasibility of using a preloaded commercially available endograft to preserve HA blood flow and maintain pelvic perfusion during endovascular aortic aneurysm repair.
Authors:
Paul J Riesenman; Joseph J Ricotta; Ravi K Veeraswamy
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  26     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  109.e1-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Vascular Surgery and Endovascular Therapy, Emory University School of Medicine, Atlanta, GA.
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