Conduit-Free Retroperitoneal Access to the Iliac Artery in Endovascular Aortic Repair in Patients With Improper
Artai Pirouzram1, Tal Martin Hörer, Thomas Larzon
1From the Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro University, Örebro, Sweden.
Insights
This study introduces a new sutureless technique for accessing the common iliac artery in patients with poor quality iliac access vessels, improving eligibility for endovascular aortic repair.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Device Technology
Background:
- Successful endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR) depend critically on adequate iliac access vessels.
- Poor iliac artery diameter or quality can exclude patients from EVAR/TEVAR or lead to perioperative complications like device delivery failure or iliac rupture.
Purpose of the Study:
- To describe a novel sutureless, conduit-free technique for accessing the common iliac artery in patients with suboptimal iliac access vessels.
- To present an alternative approach for EVAR and TEVAR in challenging anatomical scenarios.
Main Methods:
- A novel sutureless, conduit-free access technique for the common iliac artery is described.
- The technique aims to facilitate device delivery in patients with poor iliac access vessels.
- It requires less extensive surgical exposure of the iliac arteries compared to traditional methods.
Main Results:
- The described technique offers a viable solution for challenging iliac access.
- It potentially expands the patient population eligible for EVAR and TEVAR.
- Reduced surgical exposure may lead to fewer access-related complications.
Conclusions:
- This novel sutureless, conduit-free technique provides a valuable method for common iliac artery access in patients with poor vessel quality.
- It can enhance the success rates and applicability of EVAR and TEVAR procedures.
- Further studies are warranted to evaluate long-term outcomes and compare with existing techniques.
Abstract:
Successful endovascular aortic repair is highly dependent on the quality of the iliac access vessels. Patients with poor access vessels can be turned down from endovascular aortic repair or thoracic endovascular aortic repair by the treating physician. Perioperative complications such as failure to deliver the device or iliac rupture can be addressed to improper access vessels. In this article, we describe a novel technique to access the common iliac artery when access vessels are poor in diameter or quality. This sutureless conduit-free access technique can be used in TEVAR or EVAR and requires less surgical exposure of the iliac arteries.
