Novel Endovascular Approach Using the Gore Iliac Branch Endograft for Short Iliac Anatomy

Purpose: To report the use of a branched iliac endograft to maintain internal iliac artery (IIA) patency in a patient with an infrarenal aortic aneurysm and short common iliac arteries (CIA). Case Report: A 74-year-old man presented with an asymptomatic, fusiform, 67-mm infrarenal aortic aneurysm confirmed on computed tomography. The right CIA was funnel shaped and only 15 mm in length, providing no appropriate stent-graft landing zone. The left CIA measured 14 mm in diameter and 25 mm in length. Endovascular repair of the aneurysm with preservation of the IIAs was achieved using a Gore Iliac Branch Endoprosthesis for the short right CIA and a conventional limb to land in the left CIA. Follow-up scans to 24 months have shown continued patency of the IIA and no evidence of endoleak. Conclusion: The Gore Iliac Branch Endograft can be used to successfully treat patients with short CIA anatomy while preserving flow to the ipsilateral IIA, with maintained early patency of the IIA limb.

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Coil embolisation of an internal iliac artery aneurysm after surgical repair of an infrarenal aortic aneurysm

VASA ◽

10.1024/0301-1526.36.2.138 ◽

2007 ◽

Vol 36 (2) ◽

pp. 138-142 ◽

Cited By ~ 2

Author(s):

Sixt ◽

Rastan ◽

Schwarzwälder ◽

Schwarz ◽

Frank ◽

...

Keyword(s):

Aortic Aneurysm ◽

Iliac Artery ◽

Internal Iliac Artery ◽

Artery Aneurysm ◽

High Morbidity ◽

Coil Embolisation ◽

Iliac Artery Aneurysm ◽

Cross Sectional ◽

Infrarenal Aortic Aneurysm ◽

Internal Iliac

We report a case of an 86-year-old asymptomatic patient, who underwent a repair of the infrarenal abdominal aortic aneurysm 13 years ago. He presented with a left internal iliac artery (IIA) aneurysm with a short neck of 3 mm, and a partially thrombosed lumen with a cross sectional diameter of 5.6 cm and a length of 8.9 cm. With respect to the high morbidity and mortality and awareness of the recommendation to treat aneurysms larger than 3 cm in diameter, we discussed the optimal treatment options. As endoprosthesis implantation was not feasible we performed a selective coil embolisation of the distal branches of the left internal artery, which successively lead to a complete thrombosis of the aneurysm. Although coiling additive to other procedures is applied frequently, only few cases of internal iliac aneurysm were treated with coil embolisation alone. During a first outpatient visit 2 months following the procedure the aneurysm was still completely thrombosed.

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Concomitant unilateral internal iliac artery embolization and endovascular infrarenal aortic aneurysm repair

Journal of Vascular Surgery ◽

10.1016/j.jvs.2005.12.063 ◽

2006 ◽

Vol 43 (5) ◽

pp. 903-907 ◽

Cited By ~ 44

Author(s):

Chong Lee ◽

Matthew Dougherty ◽

Keith Calligaro

Keyword(s):

Aortic Aneurysm ◽

Iliac Artery ◽

Internal Iliac Artery ◽

Artery Embolization ◽

Infrarenal Aortic Aneurysm ◽

Internal Iliac ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair ◽

Internal Iliac Artery Embolization

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Morphological considerations on the origin and morphometry of the internal iliac arteries

ARS Medica Tomitana ◽

10.1515/arsm-2015-0010 ◽

2014 ◽

Vol 20 (4) ◽

pp. 219-227

Author(s):

Oana Popa ◽

P. Bordei ◽

D. Iliescu ◽

C. Ionescu

Keyword(s):

Intervertebral Disc ◽

Iliac Artery ◽

Internal Iliac Artery ◽

Single Case ◽

Front Face ◽

Iliac Arteries ◽

Internal Iliac ◽

The Right ◽

Different Levels ◽

Internal Iliac Arteries

Abstract The origin of the internal iliac artery, right and left, was studied in 76 cases, 58 cases of male (76.32% of all cases) and 18 female cases (23.68% of all cases). The origin of the internal iliac arteries was considered in relation to the spine (lumbar-sacral). The right internal iliac artery males originates in a range from the upper edge of L4 vertebra - the lower part of fin sacral. It is found that in males, in most cases, 43 cases (74.14% of male cases), right internal iliac artery originates at different levels of sacral fin. We considered that the right iliac artery low origin only the cases in the lower part of the fin sacral, 10 cases (17.24% of male cases). Cases of high origin of the artery, above the fin sacral we found it in 15 cases (25.86% of male cases). From high origins, in the upper edge of the L4 vertebra and intervertebral disc at L4-L5, I met only one single case. Right internal iliac artery in females originated in a range between the upper edges of L5 - the lower part of sacral fin. In females, the right internal iliac artery origin, is located within narrower than in men, but in women, most frequently, 14 cases (77.78% of female the cases) was the origin of the internal iliac located at different levels of sacral fin. The females have not met internal iliac origin above the L5 vertebra or intervertebral disc level L4-L5. High origin was met it in 4 cases (22.22% of female the cases) and low origin in 6 cases (33.33% of female the cases). The level of the left internal iliac artery origin we studied 78 cases, finding it in the same range as in males, i.e., the upper edge of L4 vertebra - the front of the sacrum. In males, on a number of 57 cases (73.08% of all cases) the origin of the left internal iliac artery was made between the upper edge of the vertebra L4 - the front face of the sacrum, most commonly, in 44 cases (77 19% of male the cases) located in the sacral fin. The artery high origin I found it in 9 cases (15.79% of male the cases) and low origin in 18 cases (31.58% of male the cases). I have not met artery origin at L5-S1 intervertebral disc. In terms of low origin, only in males, the left internal iliac artery originated from the anterior to the sacrum, something not found the right internal iliac artery. In females, the 18 cases followed, had their origins in the range lower half of the L5 - middle sacral fin, 17 cases (94.44% of female the cases), terminating at the sacral fin. It is found that in women the origin of the left internal iliac artery is within narrower than the other cases described so far, showing the highest level of origin, this artery in females do not possess low origin. The high origin is present in a small percentage, only 5.56% of cases, encountering any case the origin of the left internal iliac artery is located at the L4 vertebra or the intervertebral discs at L4-L5 or L5-S1. Internal iliac artery diameter was followed on 90 cases, 44 cases for the right internal iliac artery and 46 cases for left internal iliac artery. In males, the right internal iliac artery I found a caliber between 3 to 9.8 mm. In women the right internal iliac artery caliber found between 3.9 to 6.9 mm.

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Surgical Reconstruction of the Iliac Arteries Prior to Endovascular Aortic Aneurysm Repair

Journal of Endovascular Therapy ◽

10.1177/152660289700400313 ◽

1997 ◽

Vol 4 (3) ◽

pp. 307-311 ◽

Cited By ~ 8

Author(s):

Timothy A.M. Chuter ◽

Linda M. Reilly

Keyword(s):

Aortic Aneurysm ◽

Stent Graft ◽

Iliac Artery ◽

Surgical Techniques ◽

Surgical Reconstruction ◽

Common Trunk ◽

Aortic Blood Flow ◽

Iliac Arteries ◽

The Right

Purpose: To explore a method of combined endovascular/conventional treatment of abdominal aortic aneurysm (AAA), in which the iliac arteries are reconstructed by conventional surgical techniques to provide the anatomic substrate for subsequent endovascular repair of the aortic aneurysm. Method: A 77-year-old patient with severe cardiac disease was found to have a 6.5-cm AAA, bilateral common iliac artery (CIA) aneurysms, and diffusely narrowed, tortuous external iliac arteries. The left internal iliac artery was occluded. At operation, the right CIA was exposed through a transverse retroperitoneal incision under epidural anesthesia. An iliobifemoral bypass was constructed using a preformed bifurcated graft. A stent-graft was delivered through the right limb of the bifurcated iliobifemoral graft. The proximal end of the stent-graft was implanted in the neck of the aneurysm, and the distal end was deployed in the common trunk of the iliobifemoral graft, thereby excluding the AAA and both native iliac arteries from prograde arterial flow. Results: Completion angiography and follow-up contrast computed tomography showed the aneurysm to be excluded from the circulation. The patient was not intubated, was never hemodynamically unstable, and had aortic blood flow interrupted for no more than 20 seconds. In addition, he was able to resume his usual diet on the first postoperative day. He continues to be well and without evidence of endoleak at 6-month follow-up. Conclusions: This case demonstrates that iliac artery stenosis, tortuosity, and aneurysmal dilatation are not impediments to endovascular AAA exclusion. Any necessary surgical modifications of pelvic arterial anatomy can be performed before stent-graft insertion to minimize aortic occlusion time.

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In Situ Fenestration of the Internal Iliac Artery as a Bailout Technique Associated With Endovascular Repair of an Abdominal Aortic Aneurysm: Long-term Follow-up

Journal of Endovascular Therapy ◽

10.1583/jevt-12-4038r.1 ◽

2012 ◽

Vol 19 (6) ◽

pp. 716-720 ◽

Cited By ~ 14

Author(s):

Grayson H. Wheatley

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Iliac Artery ◽

Internal Iliac Artery ◽

Abdominal Aortic ◽

Long Term Follow Up ◽

Internal Iliac

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The patency of internal iliac arteries and its role in the development of buttock claudication syndrome in the remote period after open infrarenal aortic aneurysm repair

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2019-178-4-34-41 ◽

2019 ◽

Vol 178 (4) ◽

pp. 34-41

Author(s):

A. Ya. Bedrov ◽

A. A. Moiseev ◽

A. V. Belozertseva ◽

A. N. Morozov ◽

G. G. Khubulava ◽

...

Keyword(s):

Blood Flow ◽

Aortic Aneurysm ◽

Iliac Artery ◽

Internal Iliac Artery ◽

Blood Flow Rate ◽

Infrarenal Aortic Aneurysm ◽

Buttock Claudication ◽

Internal Iliac ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair

The OBJECTIVE was to study the patency of the internal iliac artery and its effect to gluteus muscles blood supply and frequency of buttock claudication occurrence in the remote period after open infrarenal aortic aneurysm repair. MATERIAL AND METHODS. Examination of 37 patients after open infrarenal aortic aneurysm repair included collection of complaints, anamnesis, making CT scan with contrast and pelvic perfusion tomography. These methods allowed to assess the patency of the prosthesis and iliac arteries, calculate average blood flow rate in buttock muscles and frequency of buttock claudication occurrence depending on the lesion of the internal iliac arteries. RESULTS. Five-year patency of the internal iliac artery was 93 %. In case of passable internal iliac artery, the average blood flow rate in the ipsilateral buttock muscles was authentically higher than the same indicator in groups with stenotic or occlusive lesion of the internal iliac artery and its branches. In case of the disturbed internal iliac artery patency, the frequency of occurrence of the buttock claudication in the same side reached 50 %. CONCLUSION. High five-year internal iliac artery patency after open infrarenal aortic aneurysm repair attested the necessity of preservation the main blood flow in these arteries during the open infrarenal aortic aneurysm repair for the purpose of buttock claudication prevention. The CT scan allowed to evaluate the internal iliac artery patency and the average blood flow rate in the buttock muscles through perfusion tomography method which was necessary for differential diagnosis of the buttock claudication syndrome.

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Total endovascular treatment for thoraco-abdominal aortic aneurysm in a patient with Behçet’s disease: Case report and literature review

Vascular ◽

10.1177/1708538120975910 ◽

2020 ◽

pp. 170853812097591

Author(s):

Mian Wang ◽

Luis M Bartolozzi ◽

Vincent Riambau

Keyword(s):

Computed Tomography ◽

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Endovascular Treatment ◽

Iliac Artery ◽

Behcet’S Disease ◽

Internal Iliac Artery ◽

Abdominal Aortic ◽

Internal Iliac

Introduction To report total endovascular treatment for a rare case of Crawford extent IV thoraco-abdominal aortic aneurysm (TAAA) using custom-designed branched device in a patient with Behçet’s disease. Methods A 50 years’ old man with history of BD was accidentally diagnosed Crawford extent IV TAAA during computed tomography follow-up after left nephrectomy of renal carcinoma. The aneurysm extended from descending aorta to right common iliac artery with a maximum diameter of 6.2 cm. Results The endovascular procedure wassuccessfully performed using custom-designed branched component to cannulate visceral arteries, bifurcated endograft and iliac legs to exclude the aneurysm sac in abdominal aorta and an iliac branched device to preserve the right internal iliac artery. The patient was discharged without any complication. Computed tomography angiogram at one month after endovascular repair demonstrated total exclusion of the aneurysm, patent visceral branches and right internal iliac artery. No complication occurred to six-month follow-up. Conclusion Endovascular treatment of stable TAAA in patients with Behc?et's disease using custom-designed branched device is feasible, microinvasive and safe. The long-term efficacy needs to be observed.

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Novel, congenital iliac arterial anatomy: Absent common iliac arteries and left internal iliac artery

Radiology Case Reports ◽

10.2484/rcr.v9i3.978 ◽

2014 ◽

Vol 9 (3) ◽

pp. 978 ◽

Cited By ~ 1

Author(s):

Christopher S. Green ◽

Mohammed A. Helmy

Keyword(s):

Iliac Artery ◽

Internal Iliac Artery ◽

Iliac Arteries ◽

Internal Iliac ◽

Arterial Anatomy ◽

Common Iliac Arteries

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Transcatheter Artery Embolization for Postoperative Haemorrhage after Arterio-Venous Malformation – Safer Option

Acta medica Lituanica ◽

10.15388/amed.2021.28.1.11 ◽

2021 ◽

Vol 28 (1) ◽

pp. 11

Author(s):

Panda Subrat ◽

Sharma Nalini ◽

Khan Dina Aisha ◽

Saha Anusmita ◽

Das Rituparna ◽

...

Keyword(s):

Internal Iliac Artery ◽

Venous Malformation ◽

Postoperative Bleeding ◽

Artery Embolization ◽

Iliac Arteries ◽

Postoperative Haemorrhage ◽

Internal Iliac ◽

Av Malformation ◽

Arterio Venous Malformation ◽

The Right

Introduction: Hemorrhage is one of the commonest and dreaded complications especially with pelvic surgeries. Gestational trophoblastic neoplasias (GTN) are notorious for their propensity to bleed torrentially and metastasis to vital organs. GTN is associated with an arterio-venous malformation (AVM) about 10-15% of the time, which can lead to bleeding after surgery or after complete remission. After the failure of conventional management with chemotherapy or surgery one is compelled to take another modality of management. One of such methods is the use of transcatheter artery embolization in cases of GTN or post-hysterectomy cases of GTN. Transcatheter artery embolization (TAE) was effective in controlling bleeding due to arterio-venous malformation in 96% of cases.Case: 46 years P2L2A5 (para 2, living issue 2, abortion 5) post-hysterectomy patient presented with bleeding from the vagina after surgery. Twice she underwent vaginal vault repair after hysterectomy but failed. Ultrasonography (USG) showed arterio-venous malformation (AVM); angiography revealed massive extravasation from (left internal iliac artery and abnormal vascularity from the right internal iliac. She was taken up for bilateral internal iliac arteries embolization but again had a heavy bout of bleeding after one week. CT scan confirmed a residual lesion and she underwent a repeat embolization after which the bleeding stopped. Serum BHCG was advised during workup and it was 1997 IU/ml. A diagnosis of GTN was confirmed. The patient was discharged after two cycles of chemotherapy with advice to review for the third one on an outpatient department basis.Conclusion: We concluded that TAE is an effective and safer alternative to surgery in postoperative bleeding from AV malformation in the case of GTN. It can be repeated and should be made to more liberal use in emergency settings.

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