A Multicenter Assessment of Anatomic Suitability for Iliac Branched Devices in Eastern Asian Patients With Unilateral and Bilateral Aortoiliac Aneurysms

Objective: This study aims to assess the suitability of four types of commercial iliac branch device systems to treat Eastern Asian abdominal aortic aneurysm (AAA) patients with bilateral or unilateral common iliac artery aneurysms (CIAAs).Methods: Patients with a coexisting AAA and a unilateral or bilateral CIAAs who underwent endovascular aneurysm repair (EVAR) at two tertiary centers in China from 2015 to 2017 were reviewed. Morphology of lesions was measured and the anatomic suitability for Cook iliac branch device (IBD), Gore iliac branch endoprosthesis (IBE), Lifetech iliac branch stent graft (IBSG), and Jotec IBD was evaluated according to the latest instructions for use.Results: Seventy-six patients with AAA were enrolled, including 35 bilateral CIAAs, 41 unilateral CIAAs. A hundred and eleven lesions were investigated aggregately: 16.2, 28.8, 21.6, and 19.8% met the criteria for Cook IBD, Gore IBE, Lifetech IBSG, and Jotec IBD, respectively. A total of 34 (44.7%) patients could be treated for at least one lateral lesion. The diameter of the internal iliac artery (IIA) was the most common restriction for IBD application. Additionally, the IIA diameter of lesions in the bilateral group was significantly larger compared with the unilateral group (P < 0.001). Based on the anatomical characteristics alone, it is likely that IBDs will be more suitable for unilateral lesions than bilateral ones (P < 0.05). However, there was no difference between the suitability for patients with unilateral or bilateral CIAAs (P > 0.05).Conclusions: Less than half of Eastern Asian patients with aortoiliac aneurysms were eligible for IBD application. This was primarily due to the IIA diameter failing to meet the criteria. And thus, the suitability of lesions in bilateral group was significantly lower than that in the unilateral group. Aiming to expand the indications and optimize the design of the iliac branch devices, IIA diameter and the anatomical characteristics of the bilateral lesions should be considered deliberately.

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

Journal of Endovascular Therapy ◽

10.1177/1526602817747283 ◽

2018 ◽

Vol 25 (1) ◽

pp. 21-27 ◽

Cited By ~ 9

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.

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Use of Bilateral Cook Zenith Iliac Branch Devices to Preserve Internal Iliac Artery Flow During Endovascular Aneurysm Repair

Journal of Vascular Surgery ◽

10.1016/j.jvs.2019.01.036 ◽

2019 ◽

Vol 69 (3) ◽

pp. 972

Author(s):

P. Marques de Marino ◽

B. Botos ◽

G. Kouvelos ◽

E.L.G. Verhoeven ◽

A. Katsargyris

Keyword(s):

Iliac Artery ◽

Internal Iliac Artery ◽

Endovascular Aneurysm Repair ◽

Internal Iliac ◽

Artery Flow ◽

Aneurysm Repair

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Three-dimensional rotational digital angiography for difficult internal iliac artery embolization in endovascular aneurysm repair candidates

Cardiovascular Revascularization Medicine ◽

10.1016/j.carrev.2007.04.004 ◽

2008 ◽

Vol 9 (1) ◽

pp. 62-63

Author(s):

Gianluca Rigatelli ◽

Fabio Dell' Avvocata ◽

Luca Zattoni ◽

Massimo Giordan ◽

Dario Adami ◽

...

Keyword(s):

Iliac Artery ◽

Internal Iliac Artery ◽

Endovascular Aneurysm Repair ◽

Three Dimensional ◽

Digital Angiography ◽

Artery Embolization ◽

Internal Iliac ◽

Aneurysm Repair ◽

Internal Iliac Artery Embolization

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Effectiveness of Embolization of Internal Iliac Artery during Endovascular Aneurysm Repair

Vascular Specialist International ◽

10.5758/kjves.2011.27.4.151 ◽

2011 ◽

Vol 27 (4) ◽

pp. 151-155 ◽

Cited By ~ 1

Author(s):

Joo Hyung Lee ◽

Hyun Ji Kim ◽

Sun Keun Choi ◽

Woo Young Shin ◽

Jang Yong Kim ◽

...

Keyword(s):

Iliac Artery ◽

Internal Iliac Artery ◽

Endovascular Aneurysm Repair ◽

Internal Iliac ◽

Aneurysm Repair

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Challenging the Evidence for Pre-emptive Coil Embolisation of the Internal Iliac Artery during Endovascular Aneurysm Repair

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2012.12.001 ◽

2013 ◽

Vol 45 (3) ◽

pp. 220-226 ◽

Cited By ~ 17

Author(s):

R.A. Stokmans ◽

E.M. Willigendael ◽

J.A.W. Teijink ◽

J.A. Ten Bosch ◽

M.R.H.M. van Sambeek ◽

...

Keyword(s):

Iliac Artery ◽

Internal Iliac Artery ◽

Endovascular Aneurysm Repair ◽

Coil Embolisation ◽

Internal Iliac ◽

Aneurysm Repair

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Management of Type II Endoleak From Internal Iliac Artery Immediately After Endovascular Aneurysm Repair

Vascular and Endovascular Surgery ◽

10.1177/1538574416687736 ◽

2017 ◽

Vol 51 (1) ◽

pp. 47-50 ◽

Cited By ~ 2

Author(s):

Ming-Yi Hsu ◽

Ta-Wei Su ◽

I-Hao Su ◽

Po-Jen Ko ◽

Sung-Yu Chu

Keyword(s):

Iliac Artery ◽

Coil Embolization ◽

Open Surgery ◽

Internal Iliac Artery ◽

Endovascular Aneurysm Repair ◽

Type Ii ◽

Type Ii Endoleak ◽

Internal Iliac ◽

A New Technique ◽

Aneurysm Repair

Inadvertent coverage of origin of internal iliac artery (IIA) during endovascular aneurysm repair may lead to type II endoleak. Except for open surgery, the endovascular solution is limited. We report a case with such complication that was successfully treated with coil embolization using retrograde extrastent approach. This is a new technique that has not been reported before, and as such, had been useful in the treatment of type II endoleak from IIA as an alternative to open ligation of IIA origin.

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