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Femoral - internal iliac bypass in aortoiliac aneurysms endovascular repair

Petr Utíkal1, Martin Köcher, Petr Bachleda

  • 12nd Clinic of Surgery, Teaching Hospital Olomouc, Czech Republic. petr.utikal@fnol.cz

Biomedical Papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
|November 4, 2004
PubMed

Insights

Femoral-internal iliac bypass can prevent ischemic complications after endovascular repair of aortoiliac aneurysms. This preventive strategy is recommended when both internal iliac arteries are overstented, based on positive outcomes in six patients.

Area of Science:

  • Vascular Surgery
  • Endovascular Repair
  • Aortoiliac Aneurysm Treatment

Background:

  • Endovascular aneurysm repair (EVAR) of the aortoiliac segment can lead to internal iliac artery (IIA) occlusion.
  • IIA occlusion may result in ischemic complications such as buttock claudication, erectile dysfunction, and colonic ischemia.
  • Overstenting of IIAs during EVAR is a common scenario necessitating management strategies to preserve IIA patency.

Purpose of the Study:

  • To describe the technique of femoral-internal iliac bypass (FIIB) for managing IIA issues post-EVAR.
  • To evaluate the efficacy of FIIB in preventing ischemic complications.
  • To assess the potential preventive indication of FIIB in specific EVAR scenarios.

Main Methods:

  • Retrospective review of six patients undergoing EVAR with bilateral IIA overstenting.
  • Description of the surgical technique for creating FIIB.
  • Assessment of postoperative outcomes and complications related to IIA perfusion.

Main Results:

  • Successful creation of FIIB in all six patients.
  • Absence of ischemic complications in the postoperative period.
  • Demonstrated patency of the bypass grafts and preserved IIA flow.

Conclusions:

  • Femoral-internal iliac bypass is a viable technique to prevent ischemic complications following EVAR when bilateral IIAs are overstented.
  • The authors recommend considering prophylactic FIIB in patients undergoing EVAR with bilateral IIA overstenting.
  • This approach ensures adequate pelvic perfusion and avoids potential IIA-related morbidity.

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