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[Thoracic Endovascular Aortic Repair Via Internal Iliac Artery Conduit]

Taro Hayashi1, Satoshi Tobe, Hironobu Sugiyama

  • 1Department of Cardiovascular Surgery, Akashi Medical Center, Akashi, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|September 3, 2016
PubMed

Insights

Thoracic endovascular aortic repair (TEVAR) was challenging due to prior stent issues. A retrograde approach via the left internal iliac artery (IIA) provided a viable access route for this complex aortic aneurysm repair.

Area of Science:

  • Vascular Surgery
  • Endovascular Interventions
  • Aortic Aneurysm Repair

Background:

  • A 77-year-old male patient presented with a rapidly growing descending thoracic aortic aneurysm.
  • The patient had a history of stent implantation in the right common iliac artery (CIA) and left external iliac artery (EIA).

Observation:

  • Significant challenges were identified for standard endovascular access.
  • These included severe calcification in the infrarenal aorta and left EIA, small stent lumens (right CIA: 5.3 mm, left EIA: 4.3 mm), and a short left CIA (13 mm).

Findings:

  • Thoracic endovascular aortic repair (TEVAR) was successfully performed using a retrograde access approach.
  • The access route utilized was the left internal iliac artery (IIA) with a tube graft conduit in a hybrid operating room.

Implications:

  • The left internal iliac artery (IIA) serves as a valuable alternative access route for endovascular aortic repair.
  • This approach can overcome limitations posed by previous interventions and complex iliac-artery anatomy.

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