Endovascular treatment of bilateral common iliac artery aneurysms using bifurcated-unibody stent grafts
Xiaojun Shu1, Zhengfei Li1, Weiping Wang2
1Department of Interventional Radiology, 1st Hospital of Lanzhou University, No. 1, West Donggang Road, Lanzhou City, Gansu Province, China.
Insights
Endovascular repair of bilateral common iliac artery aneurysms (CIAA) is feasible using specialized stent grafts. This approach offers a viable alternative for complex CIAA cases, even with short proximal necks.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aneurysm Repair
Background:
- Endovascular treatment of bilateral common iliac artery aneurysms (CIAA) presents challenges, particularly with short proximal necks and the need for internal iliac artery preservation.
- Open surgical repair is the traditional method, but endovascular options are increasingly explored.
Observation:
- A case report details the endovascular repair of a 62-year-old male with bilateral CIAA and short proximal necks.
- The right internal iliac artery was involved and subsequently occluded.
- An aorta-bi-iliac stent graft was employed to ensure adequate proximal landing zones.
Findings:
- Successful exclusion of bilateral CIAA was achieved using a bifurcated-unibody stent graft on the left, preserving the internal iliac artery.
- A conventional tubular covered stent was used on the right, resulting in internal iliac artery occlusion.
- The use of an aorta-bi-iliac stent graft provided necessary proximal landing zones for the iliac stent grafts.
Implications:
- Iliac bifurcated-unibody stent grafts represent a valuable endovascular option for treating complex CIAAs.
- Aorta-bi-iliac endografts are crucial for establishing reliable landing zones in cases of short proximal necks.
- These techniques expand endovascular capabilities for challenging iliac aneurysm cases.
Background:
Endovascular treatment of bilateral common iliac artery aneurysms (CIAA) is a promising alternative to open surgical repair. However, endovascular treatment is challenging when the CIAAs have short proximal necks and internal iliac artery needs to be preserved.
Methods/Results:
We report a case of a 62-year-old man who presented with bilateral CIAA with short proximal necks, with the right-side aneurysm extended into the internal iliac artery. The aneurysms were successfully excluded by using a bifurcated-unibody stent graft on the left with preservation of its internal iliac artery; a conventional tubular covered stent was used on the right with occlusion of its internal iliac artery. In addition, an aorta-bi-iliac artery stent was used to provide extended proximal landing zones for the iliac stents.
Conclusions:
Endovascular repair using an iliac bifurcated-unibody stent graft can be a useful approach for the treatment of CIAAs. An aorta-bi-iliac endograft may also be needed to provide a reliable landing zone when the proximal neck of the iliac aneurysm is short.
