Prospective study of the E-liac Stent Graft System in patients with common iliac artery aneurysms: 30-Day results

Vascular ◽  
2018 ◽  
Vol 26 (6) ◽  
pp. 647-656 ◽  
Author(s):  
Jan Brunkwall ◽  
Carlos Vaquero Puerta ◽  
Joerg Heckenkamp ◽  
Jose Maria Egaña Barrenechea ◽  
Piotr Szopinski ◽  
...  
Keyword(s):  
Stent Graft ◽  
Iliac Artery ◽  
Common Iliac Artery ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
External Iliac Artery ◽  
Aortic Stent Graft ◽  
Type Ia ◽  
Internal Iliac

Objectives To study the safety and feasibility of the E-liac Stent Graft System® in patients with aorto/iliac aneurysms. Methods A prospective multicentric European registry of patients receiving the E-liac Stent Graft System® was conducted. Endpoints of the study included the technical success as well as periprocedural events and 30-day endoleaks, reinterventions, internal and external iliac artery patency and mortality. Results Between July 2014 and June 2016, a total of 45 patients (93% men, mean age 72 years, range 53–90 years) were enrolled at 11 sites in four European countries. Five patients received an isolated iliac treatment. Thirty-seven patients were treated with a combination of an abdominal stent graft and a unilateral E-liac and three in combination with bilateral E-liac. All E-liac Stent Grafts (48) were implanted in the intended position and the internal iliac arteries were successfully bridged. Two patients did not receive clinical success, due to endoleak type Ia of the aortic stent graft. At 30-day follow-up, clinical success rate was 96%. Three successful endovascular reinterventions were performed within the 30-day follow-up: one due to a type Ia endoleak in the common iliac artery, one due to type Ia endoleak of the aortic stent graft, and one due to bilateral lower limb claudication provoked by stent graft limb stenosis. At 30-day, a 100% survival rate and complete absence of pelvic or buttock ischemia/claudication were reported. Primary patency at 30 days was 100% for the internal iliac artery and 98% for the external iliac artery with an assisted patency of 100% in the latter. Conclusions The high clinical success rate, low rates of device-related reinterventions (2%), and excellent patency rate demonstrate the safety and feasibility of the E-liac Stent Graft System. Long-term results are awaited to state efficacy and durability. Clinical Trials.gov. Identifier no. NCT02209194.

A Modular Multi-Branched System for Endovascular Repair of Bilateral Common Iliac Artery Aneurysms

2003 ◽  
Vol 10 (2) ◽  
pp. 203-207 ◽  
Author(s):  
Cherrie Z. Abraham ◽  
Linda M. Reilly ◽  
Darren B. Schneider ◽  
Shelley Dwyer ◽  
Rajiv Sawhney ◽  
...  
Keyword(s):  
Stent Graft ◽  
Iliac Artery ◽  
Endovascular Repair ◽  
External Iliac Artery ◽  
Modular System ◽  
Iliac Aneurysm ◽  
Short Limb ◽  
Aortic Stent Graft ◽  
Internal Iliac ◽  
The Right

Purpose: To describe a modular stent-graft for cases of bilateral common iliac aneurysm. Technique: The aortic aneurysm is repaired using a standard bifurcated modular system (Zenith). A modified bifurcated component is deployed with its trunk in one limb of the original aortic stent-graft, its long limb in the external iliac artery, and its short limb in the iliac aneurysm just above the internal iliac orifice. A flexible extension is introduced from the right brachial artery and used to bridge the gap between the short limb of the modified bifurcated component and the left internal iliac artery. Conclusions: Endovascular repair of bilateral iliac aneurysm is feasible using a modular stent-graft with separate branches to the internal and external iliac arteries.

Up-and-Over Technique for Implantation of Iliac Branch Devices After Prior Aortic Endograft Repair

2018 ◽  
Vol 25 (1) ◽  
pp. 21-27 ◽  
Author(s):  
David L. Dawson ◽  
Giuliano de Almeida Sandri ◽  
Emanuel Tenorio ◽  
Gustavo S. Oderich
Keyword(s):  
Stent Graft ◽  
Iliac Artery ◽  
Endovascular Aneurysm Repair ◽  
Covered Stent ◽  
Femoral Access ◽  
Aortic Stent Graft ◽  
Flow Divider ◽  
Device Placement ◽  
Internal Iliac ◽  
Aneurysm Repair

Purpose: To describe a modified up-and-over access technique for treatment of iliac artery aneurysms in patients with prior bifurcated stent-grafts for endovascular aneurysm repair (EVAR). Technique: This technique uses a coaxial 12-F flexible sheath that is docked with a through-and-through wire into a 7-F sheath advanced from the contralateral femoral approach. This maneuver allows both sheaths to be moved as a unit while maintaining position of the apex of the system as it loops over the flow divider, avoiding damage to or displacing the extant endograft. Once the 12-F sheath is positioned in the iliac limb of the aortic stent-graft and secured in place with the through-and-through wire, the repair is extended into the internal iliac artery using a bridging stent-graft or covered stent introduced via a coaxial sheath. Conclusion: The up-and-over technique with a flexible 12-F sheath mated with a 7-F sheath from the opposite side allows bilateral femoral access to be used for iliac branch device placement after prior aortic endograft procedures that create a higher, acutely angled bifurcation. Use of a through-and-through wire and a coaxial sheath for stent delivery creates a very stable platform for intervention.

Secondary Relining With Focal Flaring of Novel-Generation Balloon-Expandable Covered Stents for Endovascular Treatment of Significant Diameter Mismatch in the Aorto-Iliac Territory

Vascular ◽  
2020 ◽  
pp. 170853812094505
Author(s):  
Mario D’Oria ◽  
Filippo Griselli ◽  
Davide Mastrorilli ◽  
Filippo Gorgatti ◽  
Silvia Bassini ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Treatment ◽  
Stent Graft ◽  
Iliac Artery ◽  
Common Iliac Artery ◽  
Covered Stents ◽  
Abdominal Aortic ◽  
The Right

Objectives The aim of this study was to report on the safety and feasibility of secondary relining with focal flaring of novel-generation balloon-expandable covered stents for endovascular treatment of significant diameter mismatch in the aorto-iliac territory. Significant diameter mismatch was defined as >20% difference in the nominal diameter between the intended proximal and distal landing zones. Methods Patient A was an 84-year-old man with prior abdominal aortic aneurysm open repair with a straight 20 mm Dacron tube. He presented with a right common iliac artery aneurysm (Ø88 mm) with contained rupture. The Gore Viabahn endoprosthesis (9 mm × 5 cm) was inserted proximally about 15 mm above the occluded ostium of the internal iliac artery. Subsequently, the BeGraft Aortic® (16 mm × 48 mm) was inserted proximally up to the common iliac artery origin; its proximal portion was flared to 22 mm. Patient B was a 77-year-old man with prior endovascular abdominal aortic aneurysm repair with a Medtronic Endurant stent-graft. He presented with occlusion of the right limb of the aortic endoprosthesis and thrombosis that extended down to the level of the superficial femoral artery. After mechanical thrombectomy, two Gore Viabahn endoprosthesis (first one, 8 mm × 10 cm; second one, 10 mm × 15 cm) were inserted into the right iliac limb. Subsequently, the BeGraft Aortic® (12mm × 39mm) was inserted proximally up to the gate of the aortic stent-graft; its proximal portion was flared to 16 mm. Results Technical success and clinical success were achieved in both patients. Imaging follow-up (6 months for Patient A, 12 months for Patient B) showed correct placement of all stent-grafts without any graft-related adverse event. The patients remained free from new reinterventions or recurrent symptoms. Patient A died 8 months after the index procedure from acute respiratory failure after community acquired pneumonia. Conclusion Secondary relining with focal flaring of novel-generation balloon-expandable covered stents for endovascular treatment of significant diameter mismatch in the aorto-iliac territory is safe and feasible. Although mid-term results seem to be effective, longer follow-up is warranted to establish durability of the technique.

Endovascular treatment of isolated iliac artery aneurysms using a custom-made stent graft with proximal barb fixation: early outcome

Vascular ◽  
2013 ◽  
Vol 21 (2) ◽  
pp. 92-96 ◽  
Author(s):  
D L H Baird ◽  
K Mani ◽  
T Sabharwal ◽  
P R Taylor ◽  
H A Zayed
Keyword(s):  
Stent Graft ◽  
Iliac Artery ◽  
Perioperative Complications ◽  
External Iliac Artery ◽  
Stent Grafts ◽  
Landing Zone ◽  
Custom Made ◽  
Internal Iliac ◽  
The Mean ◽  
Isolated Iliac Artery Aneurysms

Current endovascular treatments for isolated iliac artery aneurysms (IIAAs) include the use of aortoiliac stent grafts with coverage of the distal aorta or stent grafts confined to the iliac artery without active proximal fixation. We report our experience in the use of custom-made Cook Zenith™ iliac limb stent grafts with proximal barb fixation. Patients treated from July 2009 to February 2011 were included. All imaging and patient records were assessed for perioperative and early outcomes. Nine IIAAs (seven patients) were treated. The mean patient age was 80 years (range 58-91 years). The mean aneurysm size was 48 mm (35-80 mm), and the mean length of the proximal landing zone (PLZ) was 29 mm (10-50 mm). The distal landing zone was in the external iliac artery after coil embolization of the internal iliac artery. The Mean diameter of the PLZ was 21 mm (20-24 mm). Technical success was achieved in eight cases. Perioperative complications included reoperation in one patient for groin bleeding and ischemia. On follow-up (mean 12 months, range 1-26), all aneurysms were successfully excluded from the circulation and there was no stent graft migration or thrombosis. Use of custom-made stent grafts with proximal barb fixation in treatment of IIAAs is a feasible option which may reduce the risk of migration when compared with stent grafts with lack of proximal fixation.

Endovascular Treatment of External Iliac Artery Injuries after Hip Arthroplasty

2003 ◽  
Vol 10 (3) ◽  
pp. 672-675 ◽  
Author(s):  
Roberto Adovasio ◽  
Fabio Pozzi Mucelli ◽  
Giovanni Lubrano ◽  
Cristiana Gasparini ◽  
Manuel Belgrano ◽  
...  
Keyword(s):  
Stent Graft ◽  
Iliac Artery ◽  
Elderly Women ◽  
Case Reports ◽  
External Iliac Artery ◽  
Hip Surgery ◽  
Hip Prostheses ◽  
Arterial Lesions ◽  
Stent Graft Repair

Purpose: To report endovascular repair of injuries to the external iliac artery during hip surgery. Case Reports: Two elderly women with histories of chronically infected hip prostheses were found to have iatrogenic leaking pseudoaneurysms of the external iliac artery due to hip surgery trauma in the past. Both were treated successfully with a Jostent Peripheral Stent-Graft. The first patient died 17 months after treatment, and the second was well, with an excluded false aneurysm, at the 6-month follow-up. Conclusions: Stent-graft repair may be an appropriate and effective treatment for some traumatic arterial lesions.

Internal iliac coverage during endovascular repair of abdominal aortic aneurysms is a safe option: A preliminary study

Vascular ◽  
2016 ◽  
Vol 25 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Vinay Kansal ◽  
Prasad Jetty ◽  
Dalibor Kubelik ◽  
George Hajjar ◽  
Andrew Hill ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Endovascular Aneurysm Repair ◽  
External Iliac Artery ◽  
Aortic Aneurysms ◽  
Type Ii ◽  
Type Ii Endoleak ◽  
Internal Iliac

Endovascular aneurysm repairs lacking suitable common iliac artery landing zones occasionally require graft limb extension into the external iliac artery, covering the internal iliac artery origin. The purpose of this study was to assess incidence of type II endoleak following simple coverage of internal iliac artery without embolization during endovascular aneurysm repair. Three hundred eighty-nine endovascular aneurysm repairs performed by a single surgeon (2004–2015) were reviewed. Twenty-seven patients underwent simple internal iliac artery coverage. Type II endoleak was assessed from operative reports and follow-up computed tomography imaging. No patient suffered type II endoleak from a covered internal iliac artery in post-operative computed tomography scans. Follow-up ranged from 0.5 to 9 years. No severe pelvic ischemic complications were observed. In conclusion, for selected cases internal iliac artery coverage without embolization is a safe alternative to embolization in endovascular aneurysm repairs, where the graft must be extended into the external iliac artery.

Endovascular therapy of arterioureteral fistulas

VASA ◽  
2020 ◽  
pp. 1-9
Author(s):  
Anne Marie Augustin ◽  
Giulia Dalla Torre ◽  
Arkadius Kocot ◽  
Thorsten Alexander Bley ◽  
Charis Kalogirou ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Clinical Success ◽  
Treatment Strategies ◽  
Case Series ◽  
Clinical Success Rate ◽  
Major Complication ◽  
External Iliac Artery ◽  
Pelvic Surgery ◽  
Oncologic Surgery ◽  
Segmental Artery

Summary: Background: Arterioureteral fistulas (AUFs) are severe pathologies of different origin and with increasing incidence frequently appear in patients with underlying extensive malignancy and after pelvic surgery. AUF therapy is challenging since symptoms are frequently non-specific and patients are often unsuitable surgical candidates due to comorbidities. Since experiences with endovascular treatment strategies are limited, the feasibility, effectiveness, and safety were evaluated in a consecutive case series. Patients and methods: A retrospective analysis of five patients with endovascular AUF exclusion was performed. Probable predisposing factors for an AUF included history of pelvic malignancy with oncologic surgery in four patients, radiotherapy in four patients, and indwelling ureteral stents in four patients. Clinical presentation, diagnostic management, and site of fistula were assessed. Furthermore, technical and clinical success as well as complications were evaluated. Results: All patients presented with gross haematuria. In four patients, haematuria occurred during endoscopic ureteral stent manipulation. Affected vessels were the internal pudendal artery in one, intrarenal segmental artery and external iliac artery in two, and internal iliac artery in another two patients. Treatment included coil embolisation (n = 2), plug embolisation (n = 3), particulate embolisation (n = 1), and covered stent implantation (n = 2). Technical success was achieved in all procedures. In two cases, re-intervention was necessary due to AUF recurrence, resulting in a clinical success rate of 60.0%. One major complication class D was documented. Conclusions: AUFs can be treated effectively and safely using endovascular techniques. Diagnostic and therapeutic management of this rare entity requires a high level of awareness for potential risk factors as well as an optimal multidisciplinary coordination.

Emergent conversion of the Ovation Stent Graft System to aortouniiliac modification via occlusion of a unilateral internal iliac artery with a stentgraft as a bailout solution

Vascular ◽  
2015 ◽  
Vol 23 (4) ◽  
pp. 440-443 ◽  
Author(s):  
Efstratios Georgakarakos ◽  
Nikolaos Schoretsanitis ◽  
Vasileios D Souftas ◽  
Chris Argyriou ◽  
Erchan Moustafa ◽  
...  
Keyword(s):  
Stent Graft ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
External Iliac Artery ◽  
Covered Stent ◽  
Contralateral Limb ◽  
Internal Iliac ◽  
Crossover Bypass ◽  
The Common ◽  
Femorofemoral Bypass

Purpose To present a case of inadvertent collapse of the contralateral limb gate caused by misorientation during the deployment of the Ovation Abdominal Stent Graft System in a narrow aortic lumen and the bailout conversion to aortouniiliac modification, using a covered stent to exclude the orifice of the internal iliac artery (IIA). Technique description Despite the repeated efforts from the femoral and brachial site, the collapsed/occluded contralateral limb gate could not be catheterized. In order to exclude successfully the orifice of the IIA, an oversized stentgraft was placed immediately at the common-to-external iliac artery (CIA-EIA) transition followed by peripheral ligation of the latter. The procedure was completed with crossover femorofemoral bypass. Conclusion Occlusion the IIA orifice with an oversized stentgraft in the CIA-EIA transition can be considered as a safe, simple, fast, and efficient bailout maneuver, followed by EIA ligation and crossover bypass.

scholarly journals Results of Endovascular Therapy of Ureteroarterial Fistulas: A Single Center Experience 

2021 ◽  
Author(s):  
Bjoern Simon ◽  
Jakob Neubauer ◽  
Martin Schoenthaler ◽  
Simon Hein ◽  
Fabian Bamberg ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Therapy ◽  
Iliac Artery ◽  
Coil Embolization ◽  
Clinical Success ◽  
Hypovolemic Shock ◽  
Case Series ◽  
Single Center ◽  
Single Center Experience

Abstract Background Ureteroarterial fistula (UAF) is a rare but potentially life threatening disease. The aim of this study was to evaluate the outcome of endovascular therapy for UAF treatment.Methods This retrospective case series evaluates a single center experience of percutaneous stent graft angioplasty and/or coil embolization for UAF. Patient follow-up included technical and early clinical success, complications and revisional procedures. Results We identified 17 UAF in 16 consecutive patients (12 male, 4 female, mean age 69.8 ±11.3 years) who underwent endovascular UAF therapy at our tertiary hospital. All patients presented with hematuria. 5/17 presented with flank pain, in 7 of 17 cases patients were in hypovolemic shock. Risk factors of UAF included chronic indwelling ureteral stents in all fistulas, pelvic exstirpatory surgery in 13 cases. In 6 cases stent grafts were placed from the common iliac artery (CIA) to the external iliac artery (EIA) following coil embolization of the proximal internal iliac artery (IIA). Stent graft placement without previous coil embolization was performed in 10 fistulas. In one case only coil embolization of the IIA was performed. Mean follow-up was 654 (range: 1 – 3269) days. All procedures were technically successful and no procedure related deaths occurred during follow-up. During the initial hospital stay hematuria disappeared in 14/17 cases. Overall, four patients suffered recurrent hematuria, which in three cases resolved after a secondary intervention. One recurrent UAF related death occurred during follow-up 229 days after initial treatment.Conclusion Endovascular therapy proves to be a safe and efficient method in UAF treatment.Evidence-based medicineLevel 4, case series.

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