Hypogastric artery preservation during aortoiliac aneurysm repair

Hypogastric artery (HA) embolization with iliac limb extension is often performed for patients with concomitant aorta and common iliac artery aneurysms at the time of standard endovascular aneurysm repair. However, symptomatic pelvic ischemia following HA exclusion can be debilitating. In this study, we described two cases of HA preservation using commercially available stent grafts. The techniques that we described enable patients with concurrent aorta and iliac aneurysms to undergo endovascular aneurysm repair without increasing the risk of pelvic ischemia. Although the long-term durability of these trifurcated graft configurations remains to be determined, the short-term results are superb. Technical considerations of these two different approaches have also been compared.