Bifurcated aortoiliac endograft limb occlusion during deployment and its bailout conversion using the external iliac artery to internal iliac artery endograft technique

Annals of Vascular Surgery
Elias KehagiasChristos V Ioannou

Abstract

Endovascular aneurysm repair has become the preferred method to treat abdominal aortic aneurysms (AAAs). The Ovation TriVascular Stent-Graft system introduces a unique concept of separation of the metal (stent) and fabric (graft) portion of the endograft's main body to facilitate delivery through ultra-low profile 14F devices. In the setting of a narrow distal aneurysmal lumen, usually due to the presence of thrombus, deployment of this endograft may be complicated by folding and collapse of the (unsupported by a stent) aortic body or limbs, making catheterization and ballooning impossible. We present a case of Ovation endograft contralateral limb collapse in a tight AAA lumen due to thrombus deposition, which led to folding and total occlusion of the limb and made limb catheterization impossible. This is a real-life example of how the external iliac artery to internal iliac artery endograft technique may be used as a bailout procedure, converting the procedure into an aortouni-iliac graft. To our knowledge, this is the first reported bailout use of this technique in English literature which may be used in selected cases.

References

Dec 1, 1996·Cardiovascular Surgery : Official Journal of the International Society for Cardiovascular Surgery·D A VorpJ Gorcsan
Feb 11, 2012·Journal of Vascular Surgery·Manish MehtaR Clement Darling
Jan 2, 2014·International Journal of Surgery·Gianpaolo CarrafielloRenzo Dionigi
Oct 8, 2014·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Arindam Chaudhuri

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