Document Detail

Use of an aortic bifurcation-sparing endograft facilitates hypogastric preservation during aortoiliac aneurysm repair.
MedLine Citation:
PMID:  22030355     Owner:  NLM     Status:  Publisher    
A significant percent of patients undergoing endovascular abdominal aortic aneurysm repair (EVAR) have concomitant common iliac artery aneurysms. While most of these patients will tolerate sacrifice of the hypogastric artery during repair, a subset will develop sequelae of hypogastric occlusion. EVAR was performed in two patients using a bifurcation-sparing unibody endograft (Powerlink, Endologix, Irvine, CA, USA). To avoid simultaneous bilateral hypogastric occlusion, one side was treated with coil embolization while the other was treated with a hypogastric graft (Viabahn, W L Gore and Associates, Flagstaff, AZ, USA). Access to the preserved hypogastric artery was obtained from a sheath inserted from the contralateral femoral artery and brought over the aortic bifurcation with the assistance of a 'rail-wire' traversing from the contralateral to ipsilateral femoral sheaths. The hypogastric limb was deployed simultaneously with the ipsilateral external iliac limb extension, creating a double-barrel flow lumen preserving both hypogastric and external iliac flow. At a mean follow-up of 5.1 months, both hypogastric limbs are patent and no endoleaks were observed. In conclusion, until commercially-produced branched hypogastric endografts are widely available, techniques such as those described above can allow for hypogastric preservation during aortoiliac aneurysm repair without the need for device modification or brachial access for hypogastric limb delivery.
Brian G Derubertis
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-26
Journal Detail:
Title:  Vascular     Volume:  -     ISSN:  1708-5381     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101196722     Medline TA:  Vascular     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Division of Vascular Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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